[Current status of therapy of CNS metastases of germ cell tumors].
The incidence of CNS metastases in germ cell tumors is 2-5% and in very advanced disease over 20%. We report on 37 patients in whom CNS metastases were diagnosed with the CAT scanner. Twenty-nine patients were subsequently treated. In 19 cases, treatment consisted of radiotherapy, 1 patient was only operated on, and in 9 cases patients received combined surgery and radiotherapy. Two patients had seminomatous germ cell tumors, 27 patients non-seminomatous tumors. HCG levels were high in 11 cases. In 31 patients the disease was in the advanced stages; in 6 the disease was at the early stage. If there was just a solitary tumor, operation was the preferred mode of treatment. Radiotherapy consisted of 50 GY whole-brain irradiation, with a tumor saturation up to 60 GY. In 2 cases we suspected radiogenic necrosis. There were no other severe side effects. Of the 37 patients, 4 obtained a long-term cure (observation time 34-90 months). Therapy must take all methods of treatment into consideration and should only be carried out in fully equipped medical centers. Only then can we hope to obtain long-term cures in individuals with this usually fatal disease.
Innere Abteilung, Klinik Bad Trissl im Tumorzentrum München.
C
C
Clemm
A
A
Gerl
T G
TG
Wendt
B
B
Pöllinger
P A
PA
Winkler
W
W
Wilmanns
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D003399:Craniotomy; D004407:Dysgerminoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D011867:Radioisotope Teletherapy; D015996:Survival Rate; D013736:Testicular Neoplasms / Q000401:mortality / Q000628:therapy*
D003037:Cobalt Radioisotopes