Primary central nervous system germ cell tumors. Effect of histologic confirmation on radiotherapy.
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.
Kersh
C R
CR
Division of Therapeutic Radiology and Oncology, University of Virginia Medical Center, Charlottesville 22908.
Constable
W C
WC
Eisert
D R
DR
Spaulding
C A
CA
Hahn
S S
SS
Jenrette
J M
JM
Marks
R D
RD
D000367:Age Factors; D001706:Biopsy; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000532:radiotherapy; D004407:Dysgerminoma / Q000175:diagnosis* / Q000532:radiotherapy; D006801:Humans; D010871:Pinealoma / Q000175:diagnosis* / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013997:Time Factors