Role of radiotherapy in treating patients with primary malignant mediastinal non-seminomatous germ cell tumor: A 21-year experience at a single institution.
BACKGROUND
The aim of this study was to investigate the clinical characteristics and outcomes of patients with primary malignant mediastinal non-seminomatous germ cell tumor (MMNSGCT) by comparing the efficacies of different treatment modalities.


METHODS
The charts of 62 consecutive patients with MMNSGCT between 1990 and 2010 were reviewed. Analyses included Kaplan-Meier survival and Cox multivariate regression.


RESULTS
There was sufficient data of 61 patients for inclusion in the study. The median age was 25 years. At diagnosis, 35 patients had tumors located in the mediastinum, 26 had lung and/or distant metastases. At a median follow-up of 47.2 months, 32 patients had died and 43 had developed progressive disease. The one, three, and five-year overall survival (OS) and progression-free survival (PFS) rates were 72.1%, 50.8%, 49.2% and 47.5%, 32.8%, 32.8%, respectively. Patients who received radiotherapy in the primary treatment regimen showed improved five-year OS (68.2% vs. 38.5%, P = 0.043), PFS (45.5% vs. 20.5%, P = 0.023), and local recurrence-free survival (LRFS) (77.3% vs. 38.5%, P = 0.003) compared with those who did not receive radiotherapy. Multivariate analysis revealed that radiotherapy was an independent prognostic factor of five-year OS (hazard ratio [HR] 0.39, P = 0.037), PFS (HR 0.42, P = 0.017), and LRFS (HR 0.31, P = 0.019).


CONCLUSIONS
Radiotherapy in a chemotherapy-based treatment regimen could significantly reduce local recurrence and improve survival of MMNGCT patients.
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Jianyang
J
Wang
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Nan
N
Bi
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Xiaozhen
X
Wang
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Zhouguang
Z
Hui
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Jun
J
Liang
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Jima
J
Lv
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Zongmei
Z
Zhou
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Qin Fu
QF
Feng
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Zefen
Z
Xiao
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Dongfu
D
Chen
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Hongxing
H
Zhang
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Weibo
W
Yin
Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Radiation Oncology Beijing, China.
Luhua
L
Wang
Germ cell tumor; mediastinal mass; prognostic factors; radiotherapy