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Primary central nervous system germ cell tumors. Effect of histologic confirmation on radiotherapy

✍ Scribed by C. Ronald Kersh; William C. Constable; Donald R. Eisert; Cynthia A. Spaulding; Seung S. Hahn; Joseph M. Jenrette III; Richard D. Marks Jr

Publisher: John Wiley and Sons
Year: 1988
Tongue: English
Weight: 513 KB
Volume: 61
Category: Article
ISSN: 0008-543X
DOI: 10.1002/1097-0142(19880601)61:11<2148::aid-cncr2820611103>3.0.co;2-q

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✦ Synopsis

Primary malignant intracranial germ cell tumors are rare lesions responsible for only 0.5% of all central nervous system (CNS) malignancy. With stereotactic localization these lesions can be safely biopsied, and histologic confirmation will affect the ultimate prognosis. This report is a multi-institutional retrospective analysis of 33 patients diagnosed with a primary CNS germ cell tumor. Tumors in 14 patients (42%) were histologically confirmed (13 germinoma and one embryonal cell carcinoma); 19 patients were treated with a presumptive diagnosis. All patients were irradiated with a dose range of 3950 cGy to 6000 cGy to the primary lesions. Eight patients received craniospinal irradiation, and 25 patients were locally treated. The 5-year actuarial survival for the entire population was 64%. The survival rate in patients with histologic confirmation was 79% versus 53% in the unbiopsied population. Radiation doses greater than 5000 cGy, radiotherapy volume, and age were prognostic factors in determining survival.

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