Radiation therapy for pineal and suprasellar germ cell tumors.
Radiation therapy (XRT) was used in the treatment of 25 patients with tumors of the pineal and suprasellar locations. A tissue diagnosis was obtained before XRT in 5 patients, and 20 were irradiated without histologic verification. The overall survival rate is 80% (76% with no evidence of disease [NED]). Megavoltage XRT was delivered to the entire neuraxis in 22 patients, and 86% (19/22) are alive from 4 to 88 months (median, 30 months) after treatment. In two of three patients treated only to local fields, tumor recurred in the spine; both are dead of disease. Biopsy-proven germinomas and multiple midline tumors responded favorably to XRT, whereas solitary pineal tumors and teratomas with marker positivity (human chorionic gonadotropin, alpha-fetoprotein) did not respond as well. The endocrinologic presentation, tumor marker status, and early response to radiation measured on computed tomography are useful means for selecting patients for radiation therapy.
Rich
T A
TA
Cassady
J R
JR
Strand
R D
RD
Winston
K R
KR
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000532:radiotherapy* / Q000601:surgery; D010870:Pineal Gland; D010871:Pinealoma / Q000532:radiotherapy; D011878:Radiotherapy / Q000009:adverse effects; D013724:Teratoma / Q000532:radiotherapy; D014057:Tomography, X-Ray Computed