Improved Outcome of Central Nervous System Germ Cell Tumors: Implications for the Role of Risk-adapted Intensive Chemotherapy.
10.3346/jkms.2010.25.3.458
- Author:
Keon Hee YOO
1
;
Soo Hyun LEE
;
Jeehun LEE
;
Ki Woong SUNG
;
Hye Lim JUNG
;
Hong Hoe KOO
;
Do Hoon LIM
;
Jong Hyun KIM
;
Hyung Jin SHIN
Author Information
1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Neoplasms, Germ Cell and Embryonal;
Central Nervous System;
Drug Therapy;
Survival
- MeSH:
Adolescent;
Antineoplastic Agents/*therapeutic use;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use;
Central Nervous System Neoplasms/pathology/*therapy;
Child;
Combined Modality Therapy;
Disease-Free Survival;
Female;
Humans;
Kaplan-Meier Estimate;
Male;
Neoplasms, Germ Cell and Embryonal/pathology/*therapy;
*Radiotherapy;
Risk Factors;
Treatment Outcome;
Tumor Markers, Biological/metabolism;
Young Adult
- From:Journal of Korean Medical Science
2010;25(3):458-465
- CountryRepublic of Korea
- Language:English
-
Abstract:
To determine the impact of treatment protocols on the outcome of central nervous system germ cell tumors (CNS-GCTs), we reviewed the medical records of 53 patients who received front-line chemotherapy from September 1997 to September 2006. Pure germinoma, normal alpha-fetoprotein level and beta-human chorionic gonadotropin level <50 mIU/mL were regarded as low-risk features and the others as high-risk. Patients from different time periods were divided into 3 groups according to the chemotherapy protocols. Group 1 (n=19) received 4 cycles of chemotherapy comprising cisplatin, etoposide and bleomycin. Group 2 (n=16) and group 3 (n=18) received 4 cycles of chemotherapy with cisplatin, etoposide, cyclophosphamide and vincristine in the former and with carboplatin, etoposide, cyclophosphamide and bleomycin in the latter. In group 2 and group 3, high-risk patients received double doses of cisplatin, carboplatin and cyclophosphamide. Radiotherapy was given after chemotherapy according to the clinical requirements. The event-free survivals of groups 1, 2, and 3 were 67.0%, 93.8%, and 100%, respectively (group 1 vs. 2, P=0.06; group 2 vs. 3, P=0.29; group 1 vs. 3, P=0.02). Our data suggest that risk-adapted intensive chemotherapy may improve the outcome of patients with malignant CNS-GCTs.
