한빛사논문
- 조회675
Kyung-Nam Koh 1, Ru Xin Wong 2, Dong-Eun Lee 3, Jung Woo Han 4, Hwa Kyung Byun 5, Hong In Yoon 5, Dong-Seok Kim 6, Chuhl Joo Lyu 4, Hyoung Jin Kang 7, Kyung Taek Hong 7, Joo Ho Lee 8, Il Han Kim 8, Ji Hoon Phi 9, Seung-Ki Kim 9, Tai-Tong Wong 10, Hsin-Lun Lee 11, I-Chun Lai 12, Yu-Mei Kang 12, Young-Shin Ra 13, Seung Do Ahn 14, Ho Joon Im 1, Wen Shen Looi 2, Sharon Yin Yee Low 15,16, Enrica Ee Kar Tan 17, Hyun Jin Park 18, Sang Hoon Shin 19, Hiroshi Fuji 20, Chang-Ok Suh 21, Yi-Wei Chen 12*, Joo-Young Kim 22*
1Division of Pediatric Hematology/Oncology, Department of Pediatrics, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
2Department of Radiation Oncology, National Cancer Centre, Singapore.
3Division of Cancer Epidemiology and Management, Research Institute, National Cancer Center, Goyang, Korea.
4Division of Pediatric Hematology and Oncology, Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
5Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
6Department of Neurosurgery, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
7Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
8Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
9Division of Pediatric Neurosurgery, Seoul National University Children's Hospital, Seoul National University College of Medicine, Seoul, Korea.
10Department of Neurosurgery, Taipei Medical University Hospital, Taipei Medical University, Taipei Taiwan.
11Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
12Division of Radiation Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.
13Division of Pediatric Neurosurgery, Department of Neurosurgery, Asan Medical Center Children's Hospital, University of Ulsan College of Medicine, Seoul, Korea.
14Department of Radiation Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
15Department of Neurosurgery, National Neuroscience Institute, Singapore.
16Neurosurgical Service, KK Women's and Children's Hospital, Singapore.
17Department of Pediatric Subspecialties, Pediatric Hematology/Oncology Service, KK Women's and Children's Hospital, Singapore.
18Center for Pediatric Oncology, National Cancer Center, Goyang, Korea.
19Neuro-Oncology Clinic, National Cancer Center, Goyang, Korea.
20Department of Radiation Oncology, National Center for Child Health and Development, Tokyo, Japan.
21Department of Radiation Oncology, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, South Korea.
22Department of Radiation Oncology, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
*Corresponding author.
Abstract
Background
This multinational study was conducted to report clinical presentations and treatment strategies in patients with intracranial germinomas across selected Asian centers, including failure patterns, risk factors, and outcomes.
Methods
A retrospective data collection and analysis of these patients, treated between 1995 and 2015 from eight healthcare institutions across four countries was undertaken.
Results
From the results, 418 patients were analyzed, with a median follow-up of 8.9 years; 79.9% of the patients were M0, and 87.6% had β-human chorionic gonadotropin values < 50 mIU/mL. The 5/10-year overall survival (OS) and recurrence-free survival (RFS) rates was 97.2%/96.2% and 89.9%/86.9%, respectively. RFS was predicted by radiotherapy (RT) field, with focal RT having the worst outcome, whereas chemotherapy usage had no impact on survival. Among patients who received chemotherapy, response to chemotherapy did not predict survival outcomes. In M0 patients, primary basal ganglia tumors predicted a worse RFS. In patients with bifocal tumors, an extended field RT were associated with better outcomes. In multivariable analysis, only RT fields were associated with RFS. In relapsed patients, salvage rates were high at 85.7%. Additionally, patients who received salvage RT had a better outcome (91.6% vs. 66.7%).
Conclusions
Survival outcomes of patients with germinoma were excellent. Thus, the focus of treatment for intracranial germinoma should be on survivorship. Further studies are warranted to find the optimal intensity and volume of radiation, including the role of chemotherapy in the survival of patients with intracranial germinomas, considering age, primary tumor location, and extent of disease.
논문정보
- Research article
- 2021년 12월 (BRIC 등록일 2022-01-05)
- 국내(교신)+국외 연구진
- 의약학 > 종양의학
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