title: Lack of benefit of spinal irradiation in the primary treatment of intracranial germinoma: a multiinstitutional, retrospective review of 180 patients.
abstract: 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.
authors.affiliation: Department of Radiology, Shinshu University, School of Medicine, Matsumoto, Japan. shikama@hsp.md.shinshu-u.ac.jp
authors.forename: Naoto
authors.initials: N
authors.lastname: Shikama
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Tanaka
authors.forename: Takafumi
authors.initials: T
authors.lastname: Toita
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Uno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohnishi
authors.forename: Jun
authors.initials: J
authors.lastname: Itami
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tada
authors.forename: Naokatsu
authors.initials: N
authors.lastname: Saeki
mesh_terms: 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
chemical_list: D003037:Cobalt Radioisotopes