[Long-term effect of chemotherapy combined with radiotherapy in treatment of intracranial germinoma: report of 39 cases].
OBJECTIVE
To evaluate the long-term effect of chemotherapy combined with radiotherapy in treatment of intracranial germinomas.


METHODS
Chemotherapy combined with radiotherapy was given to 45 patients with intracranial germinomas, 24 in the pineal region, 8 in the pineal and suprasellar regions, 4 in the suprasellar region, and 3 in the pineal region and cerebral ventricle from December 1993 to December 1996. Vincristine (VCR), methotrexate (MTX), bleomycin and cisplatin were administered for 4 days as a course of treatment. Then blood routine examination was taken twice a week and blood biochemical examination was taken once a week. A repeat course of chemotherapy was started 4 weeks after if no abnormality in blood examination was found. Local radiotherapy was taken with low to middle dosage (25 - 35 Gy) 1 - 2 months after the second course of chemotherapy. CT and/or MRI examination are made regularly. 39 patients had been followed up for 5 - 8 years.


RESULTS
Out of the 39 cases followed-up, one with the relapsing tumor had undergone operation and radiotherapy 2 years before and was given chemotherapy alone without radiotherapy re-relapsed and died in 4 years. One case relapsed 5 years after chemotherapy and radiotherapy and then was given chemotherapy for two more courses with the result of a shrinking of tumor by 80%. During the follow-up 37 patients (95%) survived without relapse of tumor and resumed their normal work or schooling.


CONCLUSIONS
Chemotherapy combined with local radiotherapy with low to middle dosage is the best choice for treatment of intracranial germinomas.
Jia
Ge
G
Department of Neurosurgery, Beijing Tiantan Hospital, Beijing 100050, China.
Luo
Shi-qi
SQ
Li
Chun-de
CD
Ma
Zhen-yu
ZY
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D002648:Child; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D018237:Germinoma / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
D001761:Bleomycin; D014750:Vincristine; D002945:Cisplatin; D008727:Methotrexate