Multi-institutional analysis of treatment modalities in basal ganglia and thalamic germinoma.

Autor: Graham RT; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Division of Hematology, Oncology and Bone Marrow Transplant, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Abu-Arja MH; Department of Pediatrics, New York-Presbyterian Brooklyn Methodist Hospital, Weill-Cornell College of Medicine, Brooklyn, New York, USA.; Division of Hematology, Oncology and Bone Marrow Transplant, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA., Stanek JR; Division of Hematology, Oncology and Bone Marrow Transplant, Nationwide Children's Hospital, Columbus, Ohio, USA., Cappellano A; Instituto de Oncologia Pediátrica GRAACC/UNIFESP, Division of Neuroncology, Sao Paulo, Brazil., Coleman C; Departments of Pediatrics, Neurology, and Neurological Surgery, University of California San Francisco, San Francisco, California, USA., Chi S; Dana Farber/Boston Children's Cancer and Blood Disorder Center, Pediatric Neuro-Oncology, Boston, Massachusetts, USA., Cooney T; Dana Farber/Boston Children's Cancer and Blood Disorder Center, Pediatric Neuro-Oncology, Boston, Massachusetts, USA., Dhall G; Division of Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA., Ellen JG; Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Finlay JL; Division of Hematology, Oncology and Bone Marrow Transplant, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA., Fisher MJ; Division of Oncology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA., Friedman GK; Division of Hematology and Oncology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA., Gajjar A; Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Gauvain K; Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri, USA., Hoffman LM; Division of Hematology/Oncology, Phoenix Children's Hospital, Phoenix, Arizona, USA., Hukin J; Division of Hematology and Oncology, Children's and Women's Health Centre of B.C., University of British Columbia, Vancouver, British Columbia, Canada., Lucas JT Jr; Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Mueller S; Departments of Pediatrics, Neurology, and Neurological Surgery, University of California San Francisco, San Francisco, California, USA., Navalkele P; Department of Pediatrics, SSM Cardinal Glennon Children's Hospital, Saint Louis University, Saint Louis, Missouri, USA., Ronsley R; Division of Hematology and Oncology, Children's and Women's Health Centre of B.C., University of British Columbia, Vancouver, British Columbia, Canada., Tinkle C; Department of Radiation Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA., Villeneuve S; Division of Hematology/Oncology, Izaak Walton Killam Hospital for Children, Halifax, Nova Scotia, Canada., Yeo KK; Dana Farber/Boston Children's Cancer and Blood Disorder Center, Pediatric Neuro-Oncology, Boston, Massachusetts, USA., Su JM; Texas Children's Cancer Center, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Margol A; Cancer and Blood Disease Institute and Division of Hematology-Oncology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA., Gottardo NG; Department of Paediatric and Adolescent Oncology/Haematology, Perth Children's Hospital, Nedlands, Western Australia, Australia., Allen J; Department of Pediatrics, NYU Langone Health, New York, New York, USA., Packer R; Center for Neuroscience and Behavioral Medicine, Brain Tumor Institute, Children's National Health System, Washington, District of Columbia, USA., Bartels U; Division of Hematology/Oncology, Pediatric Neuro-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada., Abdelbaki MS; Division of Hematology, Oncology and Bone Marrow Transplant, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.; Washington University School of Medicine, St. Louis Children's Hospital, St. Louis, Missouri, USA.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2021 Oct; Vol. 68 (10), pp. e29172. Date of Electronic Publication: 2021 Jun 14.
DOI: 10.1002/pbc.29172
Abstrakt: Background: Central nervous system (CNS) germinomas are treatment-sensitive tumors with excellent survival outcomes. Current treatment strategies combine chemotherapy with radiotherapy (RT) in order to reduce the field and dose of RT. Germinomas originating in the basal ganglia/thalamus (BGTGs) have proven challenging to treat given their rarity and poorly defined imaging characteristics. Craniospinal (CSI), whole brain (WBI), whole ventricle (WVI), and focal RT have all been utilized; however, the best treatment strategy remains unclear.
Methods: Retrospective multi-institutional analysis has been conducted across 18 institutions in four countries.
Results: For 43 cases of nonmetastatic BGTGs, the 5- and 10-year event-free survivals (EFS) were 85.8% and 81.0%, respectively, while the 5- and 10-year overall survivals (OS) were 100% and 95.5%, respectively (one patient fatality from unrelated cause). Median RT doses were as follows: CSI: 2250 cGy/cGy(RBE) (1980-2400); WBI: 2340 cGy/cGy(RBE) (1800-3000); WVI: 2340 cGy/cGy(RBE) (1800-2550); focal: 3600 cGy (3060-5400). Thirty-eight patients (90.5%) received chemotherapy. There was no statistically significant difference in the EFS based on initial field extent (p = .84). Nevertheless, no relapses were reported in patients who received CSI or WBI. Chemotherapy alone had significantly inferior EFS compared to combined therapy (p = .0092), but patients were salvageable with RT.
Conclusion: Patients with BGTGs have excellent outcomes and RT proved to be an integral component of the treatment plan. This group of patients should be included in future prospective clinical trials and the best RT field should be investigated further.
(© 2021 Wiley Periodicals LLC.)
Databáze: MEDLINE
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