title: Combined chemotherapy and radiotherapy for intracranial germinomas in adult patients: a single-institution study.
abstract: We report on our experience in the treatment of intracranial germinomas (18 pure germinomas and two germinomas with syncytiotrophoblastic giant cells) according to a strategy of radiotherapy doses and fields reduction after a neoadjuvant chemotherapy (Cisplatin-vinblastine and bleomycin combination). Radiation therapy was delivered after the completion of the third and last course of chemotherapy. For the solitary germinoma the target volume was the gross tumour volume. In the five multifocal germinoma patients the whole ventricle volume was irradiated. For the single disseminated germinoma patient we treated the whole central nervous system. The cumulative doses were 30 Gy for the pure germinomas. For the STGCs, a cumulative dose of 35 Gy was used. The median follow-up was 55 months (range 12-120). 18 patients were alive without recurrence of disease. In the two patients with STGCs the death took place 16 and 35 months after diagnosis.
authors.affiliation: Department of Neuro-Oncology, Istituto Nazionale Neurologico Carlo Besta, Milan, Italy. silvani@istituto-besta.it
authors.forename: Antonio
authors.initials: A
authors.lastname: Silvani
authors.forename: Marica
authors.initials: M
authors.lastname: Eoli
authors.forename: Andrea
authors.initials: A
authors.lastname: Salmaggi
authors.forename: Elena
authors.initials: E
authors.lastname: Lamperti
authors.forename: Laura
authors.initials: L
authors.lastname: Fariselli
authors.forename: Ida
authors.initials: I
authors.lastname: Milanesi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Broggi
authors.forename: Carlo Lazzaro
authors.initials: CL
authors.lastname: Solero
authors.forename: Sergio
authors.initials: S
authors.lastname: Giombini
authors.forename: Amerigo
authors.initials: A
authors.lastname: Boiardi
mesh_terms: D000293:Adolescent; D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D018237:Germinoma / Q000188:drug therapy* / Q000532:radiotherapy*; D005870:Giant Cell Tumors / Q000188:drug therapy / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010870:Pineal Gland / Q000473:pathology; D011829:Radiation Dosage; D016019:Survival Analysis; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin; D014747:Vinblastine; D002945:Cisplatin
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