Intracranial germ-cell tumours--treatment results and residuals.
There is only sparse information about the development of children after successful treatment for intracranial germ-cell tumours. Between January 1981 and June 1992, 26 children with intracranial germ-cell tumours were treated in the University Hospital Hamburg-Eppendorf. We report on treatment results, long standing residuals and the "quality of life" of these patients. The long-term event-free survival was 88% for the germinomas and 43% for the malignant teratomas. Of the patients 58% had no relevant functional neurological deficits and 37% had mild impairment. Only 1 patient with metastatic disease was severely handicapped. Six patients showed neuro-endocrine dysfunction. All of them had suprasellar/hypothalamic lesions and all received successful substitution therapy. As to neuropsychological functions, 53% of the patients had no or only mild disturbances. The most affected function was speed of information processing. Of the children 69% were able to proceed with their education at the same level as before therapy. The overall self-assessment revealed good results in 75% of the patients.


CONCLUSIONS
After surgical removal and radiation therapy long-term survival of intracranial germinomas amounts to 88%. Despite craniospinal axis radiation severe residuals are rare and a good quality of life is common. In malignant teratomas treatment regimens including chemotherapy are much less successful.
Haupt
C
C
Departments of Paediatrics and Neurosurgery, University Hospital Hamburg-Eppendorf, Germany.
Ancker
U
U
Muller
M
M
Herrmann
H D
HD
Schulte
F J
FJ
D000293:Adolescent; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000401:mortality; D001932:Brain Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D006233:Persons with Disabilities / Q000523:psychology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality