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Title: Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy

Abstract

Purpose: We carried out a retrospective review of patients receiving chemoradiation therapy (CRT) for intracranial germ cell tumor (GCT) using a lower dose than those previously reported. To identify an optimal GCT treatment strategy, we evaluated treatment outcomes, growth height, and neuroendocrine functions. Methods and Materials: Twenty-two patients with GCT, including 4 patients with nongerminomatous GCT (NGGCT) were treated with CRT. The median age at initial diagnosis was 11.5 years (range, 6-19 years). Seventeen patients initially received whole brain irradiation (median dose, 19.8 Gy), and 5 patients, including 4 with NGGCT, received craniospinal irradiation (median dose, 30.6 Gy). The median radiation doses delivered to the primary site were 36 Gy for pure germinoma and 45 Gy for NGGCT. Seventeen patients had tumors adjacent to the hypothalamic-pituitary axis (HPA), and 5 had tumors away from the HPA. Results: The median follow-up time was 72 months (range, 18-203 months). The rates of both disease-free survival and overall survival were 100%. The standard deviation scores (SDSs) of final heights recorded at the last assessment tended to be lower than those at initial diagnosis. Even in all 5 patients with tumors located away from the HPA, final height SDSs decreased (p = 0.018). Inmore » 16 patients with tumors adjacent to the HPA, 8 showed metabolic changes suggestive of hypothalamic obesity and/or growth hormone deficiency, and 13 had other pituitary hormone deficiencies. In contrast, 4 of 5 patients with tumors away from the HPA did not show any neuroendocrine dysfunctions except for a tendency to short stature. Conclusions: CRT for GCT using limited radiation doses resulted in excellent treatment outcomes. Even after limited radiation doses, insufficient growth height was often observed that was independent of tumor location. Our study suggests that close follow-up of neuroendocrine functions, including growth hormone, is essential for all patients with GCT.« less

Authors:
 [1];  [2];  [1];  [2];  [1]; ;  [3];  [4];  [5];  [6];  [7];  [1]
  1. Department of Radiology, Yokohama City University Graduate School of Medicine, Yokohama (Japan)
  2. (Japan)
  3. Department of Radiology, Kanagawa Children's Medical Center, Yokohama (Japan)
  4. Department of Radiology, Yokohama City University Medical Center, Yokohama (Japan)
  5. Division of Hemato-oncology/Regeneration Medicine, Kanagawa Children's Medical Center, Yokohama (Japan)
  6. Department of Neurosurgery, Kanagawa Children's Medical Center, Yokohama (Japan)
  7. Department of Endocrinology, Kanagawa Children's Medical Center, Yokohama (Japan)
Publication Date:
OSTI Identifier:
22149561
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 84; Journal Issue: 3; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; DIAGNOSIS; GERM CELLS; IRRADIATION; METABOLIC DISEASES; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY; STANDARDS

Citation Formats

Odagiri, Kazumasa, E-mail: t086016a@yokohama-cu.ac.jp, Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Omura, Motoko, Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Hata, Masaharu, Aida, Noriko, Niwa, Tetsu, Ogino, Ichiro, Kigasawa, Hisato, Ito, Susumu, Adachi, Masataka, and Inoue, Tomio. Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.12.084.
Odagiri, Kazumasa, E-mail: t086016a@yokohama-cu.ac.jp, Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Omura, Motoko, Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Hata, Masaharu, Aida, Noriko, Niwa, Tetsu, Ogino, Ichiro, Kigasawa, Hisato, Ito, Susumu, Adachi, Masataka, & Inoue, Tomio. Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy. United States. doi:10.1016/J.IJROBP.2011.12.084.
Odagiri, Kazumasa, E-mail: t086016a@yokohama-cu.ac.jp, Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Omura, Motoko, Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Hata, Masaharu, Aida, Noriko, Niwa, Tetsu, Ogino, Ichiro, Kigasawa, Hisato, Ito, Susumu, Adachi, Masataka, and Inoue, Tomio. Thu . "Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy". United States. doi:10.1016/J.IJROBP.2011.12.084.
@article{osti_22149561,
title = {Treatment Outcomes, Growth Height, and Neuroendocrine Functions in Patients With Intracranial Germ Cell Tumors Treated With Chemoradiation Therapy},
author = {Odagiri, Kazumasa, E-mail: t086016a@yokohama-cu.ac.jp and Department of Radiology, Kanagawa Children's Medical Center, Yokohama and Omura, Motoko and Department of Radiology, Kanagawa Children's Medical Center, Yokohama and Hata, Masaharu and Aida, Noriko and Niwa, Tetsu and Ogino, Ichiro and Kigasawa, Hisato and Ito, Susumu and Adachi, Masataka and Inoue, Tomio},
abstractNote = {Purpose: We carried out a retrospective review of patients receiving chemoradiation therapy (CRT) for intracranial germ cell tumor (GCT) using a lower dose than those previously reported. To identify an optimal GCT treatment strategy, we evaluated treatment outcomes, growth height, and neuroendocrine functions. Methods and Materials: Twenty-two patients with GCT, including 4 patients with nongerminomatous GCT (NGGCT) were treated with CRT. The median age at initial diagnosis was 11.5 years (range, 6-19 years). Seventeen patients initially received whole brain irradiation (median dose, 19.8 Gy), and 5 patients, including 4 with NGGCT, received craniospinal irradiation (median dose, 30.6 Gy). The median radiation doses delivered to the primary site were 36 Gy for pure germinoma and 45 Gy for NGGCT. Seventeen patients had tumors adjacent to the hypothalamic-pituitary axis (HPA), and 5 had tumors away from the HPA. Results: The median follow-up time was 72 months (range, 18-203 months). The rates of both disease-free survival and overall survival were 100%. The standard deviation scores (SDSs) of final heights recorded at the last assessment tended to be lower than those at initial diagnosis. Even in all 5 patients with tumors located away from the HPA, final height SDSs decreased (p = 0.018). In 16 patients with tumors adjacent to the HPA, 8 showed metabolic changes suggestive of hypothalamic obesity and/or growth hormone deficiency, and 13 had other pituitary hormone deficiencies. In contrast, 4 of 5 patients with tumors away from the HPA did not show any neuroendocrine dysfunctions except for a tendency to short stature. Conclusions: CRT for GCT using limited radiation doses resulted in excellent treatment outcomes. Even after limited radiation doses, insufficient growth height was often observed that was independent of tumor location. Our study suggests that close follow-up of neuroendocrine functions, including growth hormone, is essential for all patients with GCT.},
doi = {10.1016/J.IJROBP.2011.12.084},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 84,
place = {United States},
year = {2012},
month = {11}
}