Comparison between Craniospinal Irradiation and Limited-Field Radiation in Patients with Non-metastatic Bifocal Germinoma
| Autor: | Zhenyu Ma, Yanong Li, Youqi Li, Bo Li, Shuai Liu, Jiajia Chen, Wenyi Lv, Jiayi Wang, Chunde Li, Yanwei Liu, Shiqi Luo, Xiaoguang Qiu, Jiongxian Yang, Jin Feng, Li Chen |
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| Rok vydání: | 2020 |
| Předmět: |
Central Nervous System
Quality of life 0301 basic medicine Cancer Research medicine.medical_treatment Craniospinal Irradiation 03 medical and health sciences 0302 clinical medicine Medicine Non metastatic In patient Survival analysis Radiotherapy Germinoma business.industry medicine.disease Radiation therapy Bifocal germinoma 030104 developmental biology Oncology 030220 oncology & carcinogenesis Cohort Original Article business Nuclear medicine |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| DOI: | 10.4143/crt.2020.437 |
| Popis: | Purpose Whether craniospinal irradiation (CSI) could be replaced by limited-field radiation in non-metastatic bifocal germinoma remains controversial. We addressed the issue based on the data from our series and the literature. Materials and methods Data from 49 patients diagnosed with non-metastatic bifocal germinoma at our hospital during the last 10 years were collected. The Pediatric Quality of Life Inventory 4.0 was used to evaluate health-related quality of life (HRQOL). Additionally, 81 patients identified from the literature were also analyzed independently. Results In our cohort, 34 patients had tumors in the sellar/suprasellar (S/SS) plus pineal gland (PG) regions and 15 in the S/SS plus basal ganglia/thalamus (BG/T) regions. The median follow-up period was 52 months (range, 10 to 134 months). Our survival analysis showed that patients treated with CSI (n=12) or whole-brain radiotherapy (WBRT; n=34) had comparable disease-free survival (DFS; p=0.540), but better DFS than those treated with focal radiotherapy (FR; n=3, p=0.016). All 81 patients from the literature had tumors in the S/SS+PG regions. Relapses were documented in 4/45 patients treated with FR, 2/17 treated with whole-ventricle irradiation, 0/4 treated with WBRT, and 1/15 treated with CSI. Survival analysis did not reveal DFS differences between the types of radiation field (p=0.785). HRQOL analysis (n=44) in our cohort found that, compared with S/SS+PG germinoma, patients with BG/T involvement had significantly lower scores in social and school domains. However, HRQOL difference between patients treated with CSI and those not treated with CSI was not significant. Conclusion In patients with non-metastatic bifocal germinoma, it is rational that CSI could be replaced by limited-field radiation. HRQOL in patients with BG/T involvement was poorer. |
| Databáze: | OpenAIRE |
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