Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma

Prospective multicenter cohort study

Dong Soo Lee, Do Hoon Lim, Il Han Kim, Joo Young Kim, Jung Woo Han, Keon Hee Yoo, Kyung Duk Park, Hyeon Jin Park, Nack Gyun Chung, Chang Ok Suh, Dong Seok Kim

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To assess the efficacy of upfront chemotherapy followed by response-adapted reduced-dose/reduced-volume radiotherapy (RT) for intracranial germinoma. Materials and methods: Ninety-one patients from five institutions were registered in the KSPNO G051/G081 Protocol. Germinomas were classified as solitary or multiple/disseminated diseases, and upfront chemotherapy was administered. For all patients with multiple or disseminated disease, and patients with partial response after chemotherapy, 19.5–24 Gy of craniospinal irradiation plus 10.8–19.8 Gy of tumor bed boost were planned. For patients with complete response (CR), reduced-dose RT (30.6 Gy) was planned, along with a reduced field for solitary lesions. Results: The median patient age was 14 (range, 3–30) years. Sixty-five patients (71.4%) had a solitary lesion. The median follow-up duration was 67.9 (range, 6.6–119.3) months. Recurrence was not observed in 32 patients in the protocol compliant group. Four patients (4.4%) in the protocol non-compliant group experienced relapse after CR and one patient died of the disease. The 5-year and 7-year overall survival rates were 98.8% and 98.8%, while the corresponding event-free survival rates were 96.6% and 93.8%, respectively. All three patients with basal ganglia germinomas who were treated with local RT experienced recurrence outside the RT field. Among the 23 patients with pineal or suprasellar lesions who received whole-ventricle RT, there was no recurrence. Conclusions: Currently used upfront chemotherapy followed by reduced-dose, reduced-volume RT appears acceptable, when whole-ventricle RT for pineal or suprasellar tumors and, at minimum, whole-brain RT for basal ganglia/thalamus lesions are applied.

Original languageEnglish
Pages (from-to)180-186
Number of pages7
JournalRadiotherapy and Oncology
Volume138
DOIs
StatePublished - 1 Sep 2019

Fingerprint

Germinoma
Multicenter Studies
Cohort Studies
Radiotherapy
Drug Therapy
Recurrence
Basal Ganglia
Survival Rate
Craniospinal Irradiation
Thalamus
Disease-Free Survival
Neoplasms

Keywords

  • Chemotherapy
  • Craniospinal irradiation
  • Germinoma
  • Radiotherapy

Cite this

Lee, Dong Soo ; Lim, Do Hoon ; Kim, Il Han ; Kim, Joo Young ; Han, Jung Woo ; Yoo, Keon Hee ; Park, Kyung Duk ; Park, Hyeon Jin ; Chung, Nack Gyun ; Suh, Chang Ok ; Kim, Dong Seok. / Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma : Prospective multicenter cohort study. In: Radiotherapy and Oncology. 2019 ; Vol. 138. pp. 180-186.
@article{a00edc7c0d394117b5eda102c5bbe35c,
title = "Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma: Prospective multicenter cohort study",
abstract = "Purpose: To assess the efficacy of upfront chemotherapy followed by response-adapted reduced-dose/reduced-volume radiotherapy (RT) for intracranial germinoma. Materials and methods: Ninety-one patients from five institutions were registered in the KSPNO G051/G081 Protocol. Germinomas were classified as solitary or multiple/disseminated diseases, and upfront chemotherapy was administered. For all patients with multiple or disseminated disease, and patients with partial response after chemotherapy, 19.5–24 Gy of craniospinal irradiation plus 10.8–19.8 Gy of tumor bed boost were planned. For patients with complete response (CR), reduced-dose RT (30.6 Gy) was planned, along with a reduced field for solitary lesions. Results: The median patient age was 14 (range, 3–30) years. Sixty-five patients (71.4{\%}) had a solitary lesion. The median follow-up duration was 67.9 (range, 6.6–119.3) months. Recurrence was not observed in 32 patients in the protocol compliant group. Four patients (4.4{\%}) in the protocol non-compliant group experienced relapse after CR and one patient died of the disease. The 5-year and 7-year overall survival rates were 98.8{\%} and 98.8{\%}, while the corresponding event-free survival rates were 96.6{\%} and 93.8{\%}, respectively. All three patients with basal ganglia germinomas who were treated with local RT experienced recurrence outside the RT field. Among the 23 patients with pineal or suprasellar lesions who received whole-ventricle RT, there was no recurrence. Conclusions: Currently used upfront chemotherapy followed by reduced-dose, reduced-volume RT appears acceptable, when whole-ventricle RT for pineal or suprasellar tumors and, at minimum, whole-brain RT for basal ganglia/thalamus lesions are applied.",
keywords = "Chemotherapy, Craniospinal irradiation, Germinoma, Radiotherapy",
author = "Lee, {Dong Soo} and Lim, {Do Hoon} and Kim, {Il Han} and Kim, {Joo Young} and Han, {Jung Woo} and Yoo, {Keon Hee} and Park, {Kyung Duk} and Park, {Hyeon Jin} and Chung, {Nack Gyun} and Suh, {Chang Ok} and Kim, {Dong Seok}",
year = "2019",
month = "9",
day = "1",
doi = "10.1016/j.radonc.2019.06.002",
language = "English",
volume = "138",
pages = "180--186",
journal = "Radiotherapy and Oncology",
issn = "0167-8140",
publisher = "Elsevier Ireland Ltd",

}

Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma : Prospective multicenter cohort study. / Lee, Dong Soo; Lim, Do Hoon; Kim, Il Han; Kim, Joo Young; Han, Jung Woo; Yoo, Keon Hee; Park, Kyung Duk; Park, Hyeon Jin; Chung, Nack Gyun; Suh, Chang Ok; Kim, Dong Seok.

In: Radiotherapy and Oncology, Vol. 138, 01.09.2019, p. 180-186.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma

T2 - Prospective multicenter cohort study

AU - Lee, Dong Soo

AU - Lim, Do Hoon

AU - Kim, Il Han

AU - Kim, Joo Young

AU - Han, Jung Woo

AU - Yoo, Keon Hee

AU - Park, Kyung Duk

AU - Park, Hyeon Jin

AU - Chung, Nack Gyun

AU - Suh, Chang Ok

AU - Kim, Dong Seok

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Purpose: To assess the efficacy of upfront chemotherapy followed by response-adapted reduced-dose/reduced-volume radiotherapy (RT) for intracranial germinoma. Materials and methods: Ninety-one patients from five institutions were registered in the KSPNO G051/G081 Protocol. Germinomas were classified as solitary or multiple/disseminated diseases, and upfront chemotherapy was administered. For all patients with multiple or disseminated disease, and patients with partial response after chemotherapy, 19.5–24 Gy of craniospinal irradiation plus 10.8–19.8 Gy of tumor bed boost were planned. For patients with complete response (CR), reduced-dose RT (30.6 Gy) was planned, along with a reduced field for solitary lesions. Results: The median patient age was 14 (range, 3–30) years. Sixty-five patients (71.4%) had a solitary lesion. The median follow-up duration was 67.9 (range, 6.6–119.3) months. Recurrence was not observed in 32 patients in the protocol compliant group. Four patients (4.4%) in the protocol non-compliant group experienced relapse after CR and one patient died of the disease. The 5-year and 7-year overall survival rates were 98.8% and 98.8%, while the corresponding event-free survival rates were 96.6% and 93.8%, respectively. All three patients with basal ganglia germinomas who were treated with local RT experienced recurrence outside the RT field. Among the 23 patients with pineal or suprasellar lesions who received whole-ventricle RT, there was no recurrence. Conclusions: Currently used upfront chemotherapy followed by reduced-dose, reduced-volume RT appears acceptable, when whole-ventricle RT for pineal or suprasellar tumors and, at minimum, whole-brain RT for basal ganglia/thalamus lesions are applied.

AB - Purpose: To assess the efficacy of upfront chemotherapy followed by response-adapted reduced-dose/reduced-volume radiotherapy (RT) for intracranial germinoma. Materials and methods: Ninety-one patients from five institutions were registered in the KSPNO G051/G081 Protocol. Germinomas were classified as solitary or multiple/disseminated diseases, and upfront chemotherapy was administered. For all patients with multiple or disseminated disease, and patients with partial response after chemotherapy, 19.5–24 Gy of craniospinal irradiation plus 10.8–19.8 Gy of tumor bed boost were planned. For patients with complete response (CR), reduced-dose RT (30.6 Gy) was planned, along with a reduced field for solitary lesions. Results: The median patient age was 14 (range, 3–30) years. Sixty-five patients (71.4%) had a solitary lesion. The median follow-up duration was 67.9 (range, 6.6–119.3) months. Recurrence was not observed in 32 patients in the protocol compliant group. Four patients (4.4%) in the protocol non-compliant group experienced relapse after CR and one patient died of the disease. The 5-year and 7-year overall survival rates were 98.8% and 98.8%, while the corresponding event-free survival rates were 96.6% and 93.8%, respectively. All three patients with basal ganglia germinomas who were treated with local RT experienced recurrence outside the RT field. Among the 23 patients with pineal or suprasellar lesions who received whole-ventricle RT, there was no recurrence. Conclusions: Currently used upfront chemotherapy followed by reduced-dose, reduced-volume RT appears acceptable, when whole-ventricle RT for pineal or suprasellar tumors and, at minimum, whole-brain RT for basal ganglia/thalamus lesions are applied.

KW - Chemotherapy

KW - Craniospinal irradiation

KW - Germinoma

KW - Radiotherapy

UR - http://www.scopus.com/inward/record.url?scp=85068849266&partnerID=8YFLogxK

U2 - 10.1016/j.radonc.2019.06.002

DO - 10.1016/j.radonc.2019.06.002

M3 - Article

VL - 138

SP - 180

EP - 186

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

SN - 0167-8140

ER -