J Med Assoc Thai 2012; 95 (10):1327

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Management of Intracranial Germ Cell Tumors at the King Chulalongkorn Memorial Hospital
Raiyawa T , Khorprasert C , Lertbutsayanukul C , Seksarn P , Sosothikul D , Amornfa J , Shotelersuk K Mail

Objective:To study the outcome of less aggressive radiotherapy combined with surgery and chemotherapy to reduce radiation complication in the treatment of intracranial germ cell tumor (ICGCT) at the King Chulalongkorn Memorial Hospital.

Material and Method: A descriptive study was established by reviewing patients’ records from the Division of Therapeutic Radiology and Oncology admitted between 2001 and 2008. Median follow-up time was 65 months. Patient characteristics, investigations, and treatment modalities were presented in proportion. Survival analysis was evaluated by Kaplan-Meier method. The results were compared with the previous study in done in 1990 to 2000.

Results: Forty-two records were reviewed and 71% were male. The median age was 16 years. Pineal region was the most common site in 55%. Interestingly, 12% had synchronous lesions at both pineal and suprasellar regions. Out of 41 patients who had histopathological confirmation, 71% were germinoma. Out of 37 patients who had MRI spine or CSF cytology, 43% had CNS dissemination. Less aggressive radiotherapy combined with surgery and chemotherapy was increasingly utilized; however, five-year overall survival rate in all patients was 83%, comparable to 82% from the previous study. Survival rates of patients without CNS dissemination were 88% in the present study and 83% in the previous study. Survival rates adjusted for histopathology were 86% for germinoma and 76% for non-germinoma.

Conclusion: Less aggressive radiotherapy combined with surgery and chemotherapy to reduce radiation complication is an effective treatment for ICGCT.

Keywords: Intracranial germ cell tumors, Whole ventricular radiation, Management


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