CNS germinoma: Disease control and long-term functional outcome for 12 children treated with craniospinal irradiation

Thomas E. Merchant, Scot H. Sherwood, Raymond K. Mulhern, Susan R. Rose, Stephen J. Thompson, Robert A. Sanford, Larry E. Kun

Research output: Contribution to journalArticle

92 Citations (Scopus)

Abstract

Purpose: To provide evidence that radiation therapy alone in the form of craniospinal irradiation (CSI) and a boost to the primary site of disease provides effective disease control and limited additional morbidity for patients with CNS germinoma. Methods and Materials: Twelve patients with a median age of 12 years (range 9-16 years) with CNS germinoma were treated with CSI (median 25.6 Gy, range 23.4-32 Gy) and a boost to the primary site of disease (50.4 Gy, range 45-54 Gy) between January 1987 and June 1998. All patients were biopsied prior to radiation therapy and none received chemotherapy. No patients were lost to follow-up and the majority had long-term (> 45 month) pre- and postirradiation endocrine and psychology assessment.Results: All 12 patients are alive and no failures have occurred with a median follow-up of 69 months (range 14-143 months). Preirradiation endocrine deficiencies were present in 6 of 6 suprasellar tumors and 1 of 6 pineal tumors; with follow-up there was no substantial difference between age and gender adjusted pre- and postirradiation stature and weight. With long-term follow-up, there were no significant differences between pre- and postirradiation full-scale, verbal, and performance IQ scores. Conclusions: This study confirms the ability of radiation therapy alone to achieve disease control with a high rate of success in pediatric patients and demonstrates that the treatment toxicity faced by these patients may be less than anticipated. Because these patients present with substantial preexisting morbidity at diagnosis and may be of an age where the potential for radiation-related side effects is relatively small, the superiority of treatment alternatives may be difficult to prove. Copyright (C) 2000 Elsevier Science Inc.

Original languageEnglish (US)
Pages (from-to)1171-1176
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume46
Issue number5
DOIs
StatePublished - Mar 15 2000

Fingerprint

Craniospinal Irradiation
Germinoma
Central Nervous System Diseases
irradiation
radiation therapy
Radiotherapy
acceleration (physics)
tumors
Pinealoma
psychology
Morbidity
Aptitude
Lost to Follow-Up
chemotherapy
toxicity
Radiation
Pediatrics
Psychology
Weights and Measures
Drug Therapy

Keywords

  • CNS neoplasms
  • Germinoma
  • Pediatrics
  • Radiotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

CNS germinoma : Disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. / Merchant, Thomas E.; Sherwood, Scot H.; Mulhern, Raymond K.; Rose, Susan R.; Thompson, Stephen J.; Sanford, Robert A.; Kun, Larry E.

In: International Journal of Radiation Oncology Biology Physics, Vol. 46, No. 5, 15.03.2000, p. 1171-1176.

Research output: Contribution to journalArticle

Merchant, Thomas E. ; Sherwood, Scot H. ; Mulhern, Raymond K. ; Rose, Susan R. ; Thompson, Stephen J. ; Sanford, Robert A. ; Kun, Larry E. / CNS germinoma : Disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. In: International Journal of Radiation Oncology Biology Physics. 2000 ; Vol. 46, No. 5. pp. 1171-1176.
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AU - Thompson, Stephen J.

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AB - Purpose: To provide evidence that radiation therapy alone in the form of craniospinal irradiation (CSI) and a boost to the primary site of disease provides effective disease control and limited additional morbidity for patients with CNS germinoma. Methods and Materials: Twelve patients with a median age of 12 years (range 9-16 years) with CNS germinoma were treated with CSI (median 25.6 Gy, range 23.4-32 Gy) and a boost to the primary site of disease (50.4 Gy, range 45-54 Gy) between January 1987 and June 1998. All patients were biopsied prior to radiation therapy and none received chemotherapy. No patients were lost to follow-up and the majority had long-term (> 45 month) pre- and postirradiation endocrine and psychology assessment.Results: All 12 patients are alive and no failures have occurred with a median follow-up of 69 months (range 14-143 months). Preirradiation endocrine deficiencies were present in 6 of 6 suprasellar tumors and 1 of 6 pineal tumors; with follow-up there was no substantial difference between age and gender adjusted pre- and postirradiation stature and weight. With long-term follow-up, there were no significant differences between pre- and postirradiation full-scale, verbal, and performance IQ scores. Conclusions: This study confirms the ability of radiation therapy alone to achieve disease control with a high rate of success in pediatric patients and demonstrates that the treatment toxicity faced by these patients may be less than anticipated. Because these patients present with substantial preexisting morbidity at diagnosis and may be of an age where the potential for radiation-related side effects is relatively small, the superiority of treatment alternatives may be difficult to prove. Copyright (C) 2000 Elsevier Science Inc.

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