title: Treatment and long-term outcome of pineal nongerminomatous germ cell tumors.
abstract: In 1994 we reported on a small series of 3 children with malignant, marker-positive pineal nongerminomatous germ cell tumors treated with a 'sandwich' protocol. Here, we report on the long-term survival of these children. Preoperative chemotherapy consisted of two courses of bleomycin, etoposide, and cisplatin. En bloc resection of the tumors via the supracerebellar, infratentorial route was performed immediately after decline of tumor marker levels. Postoperatively, two courses of vinblastine, ifosfamide, and cisplatin were applied, followed by craniospinal irradiation. The patients showed no major neurological deficits and no evidence (neuroradiologically or with regard to tumor marker levels) of recurrence of disease after 66, 71, and 78 months, respectively. We propose this regimen for children with tumors of the pineal region in whom the tumor markers are positive. It should be started without histological classification of the tumor to avoid possible spillage of malignant tumor cells to the cerebrospinal fluid.
authors.affiliation: Department of Neurological Surgery, University Hospital Eppendorf, Hamburg, Germany.
authors.forename: U J
authors.initials: UJ
authors.lastname: Knappe
authors.forename: K
authors.initials: K
authors.lastname: Bentele
authors.forename: M
authors.initials: M
authors.lastname: Horstmann
authors.forename: H D
authors.initials: HD
authors.lastname: Herrmann
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018237:Germinoma / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010870:Pineal Gland / Q000473:pathology*; D013724:Teratoma / Q000188:drug therapy* / Q000473:pathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents