HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Submit a response View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Shibamoto, Y. Articles by Hiraoka, M. Search for Related Content PubMed PubMed Citation Articles by Shibamoto, Y. Articles by Hiraoka, M.

Intracranial Germinoma: Radiation Therapy with Tumor Volume-based Dose Selection¹

¹ From the Departments of Oncology, Institute for Frontier Medical Sciences (Y.S.), and Therapeutic Radiology and Oncology (K.S., N.O., M.H.), Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan. From the 1999 RSNA scientific assembly. Received November 30, 1999; revision requested December 30; final revision received April 3, 2000; accepted May 1. Supported in part by the Grant-in-Aid for Scientific Research (B) from the Japanese Ministry of Education, Science and Culture (10557087, 07455339, 11877152). Address correspondence to Y.S. (e-mail: yuta@frontier.kyoto-u.ac.jp).

PURPOSE: To prospectively investigate whether intracranial germinomas, except large ones, can be cured with radiation doses lower than 50 Gy and to determine 10-year follow-up results.

MATERIALS AND METHODS: Between 1985 and 1995, 38 patients with intracranial germinoma diagnosed histologically or with established criteria were enrolled. Total radiation doses to the primary tumor site were 36 Gy after total removal, 40 Gy for tumors less than 2.5 cm in diameter, 45 Gy for those 2.5–4.0 cm, and 50 Gy for those greater than 4.0 cm, with 1.6–1.8-Gy daily fractions. Patients underwent irradiation of the primary tumor site or cerebrospinal axis (20–24 Gy), depending on findings at diagnosis. No chemotherapy was allowed.

RESULTS: All patients completed radiation therapy. Thirty-five patients were treated according to protocol, and three with relatively slow tumor regression or presence of a cyst received additional radiation (5–7 Gy, 50–52 Gy total). Ten-year overall and relapse-free survival rates were 91% and 95%, respectively. Two patients developed meningeal dissemination, but none had local failure. Treatment complications included chordoma in one patient and internal carotid artery occlusion in another. No treatment-related decline of performance status was observed in the other patients.

CONCLUSION: All tumor volume–based radiation doses were effective, without risk of local failure. Intracranial germinoma 4 cm or less in diameter can be cured with doses of 40–45 Gy. Investigation of further dose reduction seems worthwhile. Radiation therapy alone with these doses should be compared with ongoing chemotherapeutic protocols plus low-dose (24–30-Gy) irradiation in future studies.

Index terms: Brain neoplasms, 10.361 • Brain neoplasms, therapeutic radiology, 10.1269 • Dosimetry • Germ cell neoplasm, 10.361 • Spinal cord, therapeutic radiology, 30.1269

This article has been cited by other articles:

				A. T. Reddy, J. C. Wellons III, J. C. Allen, J. B. Fiveash, H. Abdullatif, K. W. Braune, and P. A. Grabb Refining the staging evaluation of pineal region germinoma using neuroendoscopy and the presence of preoperative diabetes insipidus Neuro-oncol, April 1, 2004; 6(2): 127 - 133. [Abstract] [PDF]

eLetters: