Factors Influencing Craniospinal Relapse of Intracranial Germinoma After Complete Remission

Tsurubuchi, Takao; Hara, Kei; Takano, Shingo; Muroi, Ai; Fukushima, Hiroko; Mizumoto, Masashi; Sakamoto, Noriaki; Matsuda, Masahide; Akutsu, Hidenori; Sakurai, Hideyuki; Ishikawa, Eiichi

doi:10.1016/j.wneu.2022.07.010

Cited by 3 publications

(3 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The remaining were retrospective studies (Table S1). 14,18–50 We identified a total of 131 potentially eligible patients. Screening the patients against the exclusion criteria excluded 34 patients from the analysis.…”

Section: Resultsmentioning

confidence: 99%

The role of neoadjuvant chemotherapy in the management of metastatic central nervous system germinoma: A meta‐analysis

Abu‐Arja,

Shatara,

Okcu

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

BackgroundThe role of neoadjuvant chemotherapy in treating patients with metastatic central nervous system (CNS) germinoma is controversial.MethodsWe compared the relapse‐free survival (RFS) of different treatment modalities by performing a meta‐analysis using published data. We summarized all data using standard descriptive statistics. We used the Kaplan–Meier method to estimate RFS and their corresponding 95% confidence intervals (CIs). We used the log‐rank test for the comparison of survival functions.ResultsWe identified 97 patients with a median age at presentation of 15 years (range: 7–38). Sites of metastasis were cerebrospinal fluid (CSF) disease only (n = 12), brain parenchyma (n = 18), spinal cord (n = 9), ventricular and CSF (n = 10), ventricular only (n = 31), and other (n = 17). The 3‐year RFS among patients who received any form of radiotherapy was 89% (95% CI: 83–96) compared with 0% for patients who received a chemotherapy‐only regimen (p = .001). Five‐year RFS among patients who received craniospinal irradiation (CSI) was 92% (95% CI: 84–100) compared with 76.4% (95% CI: 63–90) in the non‐CSI group (with or without neoadjuvant chemotherapy) (p = .014). Five‐year RFS of patients who received CSI less than 24 Gy with neoadjuvant chemotherapy was 100% compared with 92% (95% CI: 83–100) CSI dose greater than or equal to 24 Gy alone (p = .3).ConclusionsOur analysis does not support avoiding spinal irradiation among patients with radiographic metastatic CNS germinoma. Future studies are needed to confirm whether neoadjuvant chemotherapy will allow a reduction of irradiation dose without compromising survival.

show abstract

Section: Resultsmentioning

confidence: 99%

The role of neoadjuvant chemotherapy in the management of metastatic central nervous system germinoma: A meta‐analysis

Abu‐Arja,

Shatara,

Okcu

et al. 2023

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…[ 11 , 19 ] However, it should be taken into account that even after 10 years, distant recurrences may occur, especially in germinoma patients who have received incomplete radiotherapy. [ 27 ] Since intracranial germinomas are known to spread through the cerebrospinal fluid, the radiation field often includes all the ventricles. [ 3 , 27 ] Although the limited number of cases made detailed analysis difficult, the main causes of death were cardiac arrest or respiratory failure within 8 months, and half of these cases occurred before radiotherapy or chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…[ 27 ] Since intracranial germinomas are known to spread through the cerebrospinal fluid, the radiation field often includes all the ventricles. [ 3 , 27 ] Although the limited number of cases made detailed analysis difficult, the main causes of death were cardiac arrest or respiratory failure within 8 months, and half of these cases occurred before radiotherapy or chemoradiotherapy. There was only one death due to germinoma itself after chemoradiotherapy, indicating that medulla oblongata germinomas are also chemo-radiosensitive and lead to a high patient survival rate after chemoradiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Preoperatively difficult-to-diagnose medulla oblongata germinoma: A case report and literature review

Karita,

Koiso,

Muroi

et al. 2023

Surgical Neurology International

Self Cite

View full text Add to dashboard Cite

Background: Intracranial germinomas are rare tumors, accounting for 0.5–2% of primary intracranial neoplasms. While they typically occur in the pineal gland, suprasellar region, basal ganglia, and thalamus, germinomas arising in the medulla oblongata are exceptionally rare. Diagnosis of medulla oblongata germinoma is challenging, potentially leading to misdiagnosis and poor prognosis. Case Description: We present a case of a 29-year-old man complaining of left leg numbness. Radiological findings revealed a contrast-enhanced lesion in the medulla oblongata. The patient underwent tumor biopsy, and intraoperative pathological diagnosis (IOD) suspected the diagnosis of medulla oblongata germinoma. He underwent chemoradiotherapy after confirming the diagnosis of germinoma. Intracranial germinoma arising in the medulla oblongata differs from germinomas in other locations due to its higher incidence in individuals in their 20s and a slight female predominance. Conclusion: When encountering lesions in the medulla oblongata, germinoma should be considered as one of the differential diagnoses, and surgical strategies including IOD should be planned accordingly.

show abstract

Antineoplastics

2023

Reactions Weekly

View full text Add to dashboard Cite

Factors Influencing Craniospinal Relapse of Intracranial Germinoma After Complete Remission

Cited by 3 publications

References 44 publications

The role of neoadjuvant chemotherapy in the management of metastatic central nervous system germinoma: A meta‐analysis

The role of neoadjuvant chemotherapy in the management of metastatic central nervous system germinoma: A meta‐analysis

Preoperatively difficult-to-diagnose medulla oblongata germinoma: A case report and literature review

Antineoplastics

Contact Info

Product

Resources

About