title: Treatment outcome of radiation therapy for intracranial germinoma: adaptive radiation field in relation to response to chemotherapy.
abstract: OBJECTIVE
  To determine the optimal radiotherapy (RT) target volume in correlation with tumor response to chemotherapy in patients with intracranial germinoma.
  
  
  METHODS
  Seventy-two patients received chemotherapy followed by RT. The RT field was tailored to chemotherapy response.
  
  
  RESULTS
  Five-year recurrence-free survival (RFS) was 87% and overall survival was 97%. RT field was significantly associated with RFS, with 5-year RFS rates of 95%, 91%, and 62% in those who received craniospinal irradiation, whole-brain/whole-ventricle RT, and focal RT, respectively (p=0.01). In the complete-response group after chemotherapy, 5-year RFS rates were 100% after whole-brain RT/whole-ventricle RT and 70% after focal RT (p=0.04). In the partial-response group, 5-year RFS rates after craniospinal irradiation, whole-brain RT, and focal RT were 100%, 85%, and 33%, respectively (p<0.01).
  
  
  CONCLUSIONS
  Regardless of response, those treated with focal RT had an excessively high relapse rate. Whole-brain/whole-ventricle RT could be applied to patients who show a complete response to chemotherapy, but the optimal strategy for patients with partial response needs further investigation.
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hyeon
authors.initials: JH
authors.lastname: Joo
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea jpark@amc.seoul.kr.
authors.forename: Jin-Hong
authors.initials: JH
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Young-Shin
authors.initials: YS
authors.lastname: Ra
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Ho Joon
authors.initials: HJ
authors.lastname: Im
authors.affiliation: Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung Nam
authors.initials: KN
authors.lastname: Koh
authors.affiliation: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Shin Kwang
authors.initials: SK
authors.lastname: Khang
authors.affiliation: Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung
authors.initials: S
authors.lastname: Do Ahn
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D002648:Child; D016371:Cranial Irradiation; D005260:Female; D005500:Follow-Up Studies; D018237:Germinoma / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D011879:Radiotherapy Dosage; D016896:Treatment Outcome; D055815:Young Adult
keywords: Intracranial germinoma; chemotherapy; radiotherapy