Lack of benefit of spinal irradiation in the primary treatment of intracranial germinoma: a multiinstitutional, retrospective review of 180 patients.
BACKGROUND
The current study assessed the contribution of spinal irradiation to the treatment outcome of patients with intracranial germinoma.


METHODS
Clinical data from 180 patients with intracranial germinoma, who were treated with radiotherapy and/or chemotherapy from 1980 to 2001, were collected from 6 institutions. The patients' median age was 16 years (range, 1-47 yrs), and the male-to-female ratio was 133:47. Pathologic verification was obtained in 88 patients. A solitary tumor was seen in 129 patients, and multifocal or disseminated tumors were detected in 51 patients. The median tumor size was 2.5 cm (range, 0.6-7.0 cm). Local field and/or whole brain irradiation was performed in 114 patients, and craniospinal irradiation was performed in 66 patients. Fifty-five patients were treated with chemotherapy. The median follow-up time was 89 months (range, 3-297 mos).


RESULTS
Eight-year overall and event-free survival rates were 91% and 89%, respectively. The 8-year recurrence rates at the primary site, intracranial space, and the spinal space were 1%, 6%, and 6%, respectively. Cox regression analysis showed that spinal irradiation (hazard ratio, 1.050; 95% confidence interval [CI], 0.355-3.170) did not contribute to a favorable event-free survival.


CONCLUSIONS
Spinal irradiation did not contribute to favorable event-free survival in patients with intracranial germinoma.
Shikama
Naoto
N
Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan. shikama@hsp.md.shinshu-u.ac.jp
Ogawa
Kazuhiko
K
Tanaka
Shiro
S
Toita
Takafumi
T
Nakamura
Katsumasa
K
Uno
Takashi
T
Ohnishi
Hiroshi
H
Itami
Jun
J
Tada
Tsuyoshi
T
Saeki
Naokatsu
N
D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D018237:Germinoma / Q000532:radiotherapy* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011882:Radiotherapy, High-Energy / Q000009:adverse effects; D012189:Retrospective Studies; D013131:Spine / Q000528:radiation effects*; D015996:Survival Rate
D003037:Cobalt Radioisotopes