Therapeutic dilemma of disseminated CNS germinoma and the potential of increased platinum-based chemotherapy delivery with osmotic blood-brain barrier disruption

E. A. Neuwelt, P. C. Wiliams, B. E. Mickey, E. P. Frenkel, W. D. Henner

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

In contrast to disseminated extraneural germinoma, systemic chemotherapy in disseminated central nervous system germinoma often results in only transient responses. After surgery, cytoreduction was accomplished with systemic multiagent platinum-based chemotherapy in 4 consecutive patients known to have a poor prognosis, due to central nervous system germinoma at more than one anatomic site. When tumor enhancement resolved (i.e., blood- brain barrier integrity was restored), intensive consolidation therapy with carboplatin and etoposide was given in association with mannitol-induced osmotic blood-brain barrier disruption. Complete responses occurred in all 4 patients and currently 3 are tumor-free without radiotherapy 24-40 months from diagnosis, suggesting the importance of increased drug delivery for an extended period.

Original languageEnglish (US)
Pages (from-to)16-22
Number of pages7
JournalPediatric Neurosurgery
Volume21
Issue number1
StatePublished - 1994

Fingerprint

Germinoma
Platinum
Blood-Brain Barrier
Drug Therapy
Central Nervous System
Carboplatin
Mannitol
Etoposide
Neoplasms
Radiotherapy
Therapeutics
Pharmaceutical Preparations

Keywords

  • Blood-brain barrier disruption
  • Disseminated CNS germinoma
  • Platinum- based chemotherapy

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health

Cite this

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abstract = "In contrast to disseminated extraneural germinoma, systemic chemotherapy in disseminated central nervous system germinoma often results in only transient responses. After surgery, cytoreduction was accomplished with systemic multiagent platinum-based chemotherapy in 4 consecutive patients known to have a poor prognosis, due to central nervous system germinoma at more than one anatomic site. When tumor enhancement resolved (i.e., blood- brain barrier integrity was restored), intensive consolidation therapy with carboplatin and etoposide was given in association with mannitol-induced osmotic blood-brain barrier disruption. Complete responses occurred in all 4 patients and currently 3 are tumor-free without radiotherapy 24-40 months from diagnosis, suggesting the importance of increased drug delivery for an extended period.",
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T1 - Therapeutic dilemma of disseminated CNS germinoma and the potential of increased platinum-based chemotherapy delivery with osmotic blood-brain barrier disruption

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AU - Wiliams, P. C.

AU - Mickey, B. E.

AU - Frenkel, E. P.

AU - Henner, W. D.

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AB - In contrast to disseminated extraneural germinoma, systemic chemotherapy in disseminated central nervous system germinoma often results in only transient responses. After surgery, cytoreduction was accomplished with systemic multiagent platinum-based chemotherapy in 4 consecutive patients known to have a poor prognosis, due to central nervous system germinoma at more than one anatomic site. When tumor enhancement resolved (i.e., blood- brain barrier integrity was restored), intensive consolidation therapy with carboplatin and etoposide was given in association with mannitol-induced osmotic blood-brain barrier disruption. Complete responses occurred in all 4 patients and currently 3 are tumor-free without radiotherapy 24-40 months from diagnosis, suggesting the importance of increased drug delivery for an extended period.

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