title: Management of intracranial germ cell tumors at the King Chulalongkorn Memorial Hospital.
abstract: OBJECTIVE
  To study the outcome of less aggressive radiotherapy combined with surgery and chemotherapy to reduce radiation complication in the treatment of intracranial germ cell tumor (ICGCT) at the King Chulalongkorn Memorial Hospital.
  
  
  METHODS
  A descriptive study was established by reviewing patients' records from the Division of Therapeutic Radiology and Oncology admitted between 2001 and 2008. Median follow-up time was 65 months. Patient characteristics, investigations, and treatment modalities were presented in proportion. Survival analysis was evaluated by Kaplan-Meier method. The results were compared with the previous study in done in 1990 to 2000.
  
  
  RESULTS
  Forty-two records were reviewed and 71% were male. The median age was 16 years. Pineal region was the most common site in 55%. Interestingly, 12% had synchronous lesions at both pineal and suprasellar regions. Out of 41 patients who had histopathological confirmation, 71% were germinoma. Out of 37 patients who had MRI spine or CSF cytology, 43% had CNS dissemination. Less aggressive radiotherapy combined with surgery and chemotherapy was increasingly utilized; however five-year overall survival rate in all patients was 83%, comparable to 82% from the previous study. Survival rates of patients without CNS dissemination were 88% in the present study and 83% in the previous study. Survival rates adjusted for histopathology were 86% for germinoma and 76% for non-germinoma.
  
  
  CONCLUSIONS
  Less aggressive radiotherapy combined with surgery and chemotherapy to reduce radiation complication is an effective treatment for ICGCT.
authors.affiliation: Division of Therapeutic Radiology and Oncology, Department of Radiology, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand.
authors.forename: Tassapong
authors.initials: T
authors.lastname: Raiyawa
authors.forename: Chonlakiet
authors.initials: C
authors.lastname: Khorprasert
authors.forename: Chawalit
authors.initials: C
authors.lastname: Lertbutsayanukul
authors.forename: Panya
authors.initials: P
authors.lastname: Seksarn
authors.forename: Darintr
authors.initials: D
authors.lastname: Sosothikul
authors.forename: Jiraphorn
authors.initials: J
authors.lastname: Amornfa
authors.forename: Kanjana
authors.initials: K
authors.lastname: Shotelersuk
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D013785:Thailand; D016896:Treatment Outcome; D055815:Young Adult