title: Clinical analysis of intracranial germinoma's craniospinal irradiation using helical tomotherapy.
abstract: OBJECTIVE
  To evaluate the short-term clinical outcomes of intracranial germinoma patients treated with craniospinal irradiation (CSI) using helical tomotherapy (HT) system in our center.
  
  
  METHODS
  Twenty-three patients who were treated with CSI in our center from January 2008 to July 2012 were collected, with an average age of 20. All of the patients' CSI used the HT system. The total doses were 27-36 Gy/15-20 F (1.5-2 Gy per fraction), and total local doses were 46-60 Gy/30-50 F (5 fractions per week). All female patients for CSI were treated with left-right parallel-opposed field irradiation to protect their ovarian functions. Median follow-up time was 30.9 months (range, 5-67 months). The SPSS19.0 software was used, and the overall survival (OS) was calculated using the Kaplan-Meier method.
  
  
  RESULTS
  Among 17 patients with assessable tumors, 9 cases (52.9%) were CR, 7 cases (41.2%) were PR, and 1 case (5.9%) was SD. Hematological toxicity was the severest side-effect occurred in the procedure of CSI. The level 1-4 acute leukopenia were 8.7%, 30.4%, 34.8% and 21.7% and the level 1-4 acute thrombopenia were 8.7%, 30.4%, 21.7% and 8.7%, respectively.
  
  
  CONCLUSIONS
  For primary intracranial germinomas, HT can be used to implement CSI for simplifying radiotherapy procedures, improving radiotherapy accuracy, enhancing protection of peripheral organs at risk (ORA) and guaranteeing therapeutic effects. With the acceptable acute and long-term toxicity, CSI using HT in intracranial germinoma patients can be a safe and alternative mode.
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Baolin
authors.initials: B
authors.lastname: Qu
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Du
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Yurong
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Boning
authors.initials: B
authors.lastname: Cai
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Shouping
authors.initials: S
authors.lastname: Xu
authors.affiliation: Department of Radiotherapy, PLA General Hospital, Beijing 100853, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
keywords: Germinomas; craniospinal irradiation (CSI); helical tomotherapy (HT)