Analysis of therapeutic effect of pediatric patients with intracranial primary non-germinomatous germ cell tumors
10.3760/cma.j.cn113030-20210906-00350
- VernacularTitle:儿童颅内原发性非生殖细胞瘤性生殖细胞肿瘤疗效分析
- Author:
Xuejiao SHI
1
;
Renhua ZHOU
;
Dongqing LU
;
Qing ZHOU
;
Chuanying ZHU
;
Shuxian CHEN
;
Yiyuan LI
;
Mawei JIANG
Author Information
1. 上海交通大学医学院附属新华医院肿瘤科，上海 200092
- Keywords:
Intracranial non-germinomatous germ cell tumors;
Child;
Radiotherapy;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2022;31(10):879-883
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical features of pediatric patients with intracranial primary non-germinomatous germ cell tumors (NGGCT) and evaluate the treatment outcomes and prognostic factors of NGGCT.Methods:Clinical data of 40 children with NGGCT who were treated with radiotherapy (RT) at our department between November 2008 and June 2019 were retrospectively analyzed. Ninety percent of them received craniospinal irradiation (CSI). All children received platinum-based chemotherapy. Survival analysis was conducted using the Kaplan-Meier estimate. The prognostic factors were analyzed by log-rank test.Results:The primary sites were pineal gland, sellar / suprasellar region and basal ganglia. The median age of onset was 108 months (20-204 months). The median follow-up time was 33 months (8-131 months), and the 3-year and 5-year overall survival (OS) rates were 82.0%. The 3-year and 5-year progression-free survival (PFS) rates were 78.6% and 73.0%. Univariate analysis showed that increased alpha-fetoprotein (AFP) ( P=0.02), age at first diagnosis>10 years ( P=0.006), metastasis at first diagnosis ( P<0.001), and the pathological type (choriocarcinoma, yolk sac tumor and / or embryonal carcinoma) ( P=0.036) were independent adverse prognostic factors. Conclusions:Increased AFP, age>10 years at first diagnosis, tumor metastasis and pathological type were independent adverse prognostic factors of NGGCT. The overall prognosis of NGGCT children is worse than that of their counterparts with germinoma, and multidisciplinary intensive therapy is needed to improve survival.
