Andrea C Lo1,2,3,4, Normand Laperriere5,6,7, David Hodgson5,6,7, Eric Bouffet6,7, James Nicholson8, Michael McKenzie9,10, Juliette Hukin11,10, Sylvia Cheng11,10, Karen J Goddard9,11,10. 1. BC Cancer, 600 W. 10th Avenue, Vancouver, BC, V5Z 4E1, Canada. Andrea.Lo@bccancer.bc.ca. 2. Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2C1, Canada. Andrea.Lo@bccancer.bc.ca. 3. University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada. Andrea.Lo@bccancer.bc.ca. 4. University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada. Andrea.Lo@bccancer.bc.ca. 5. Princess Margaret Cancer Centre, 610 University Ave, Toronto, ON, M5G 2C1, Canada. 6. The Hospital of Sick Children, 555 University Ave, Toronto, ON, M5G 1X8, Canada. 7. University of Toronto, 27 King's College Cir, Toronto, ON, M5S, Canada. 8. Addenbrooke's Hospital, Hills Rd, Cambridge, CB2 0QQ, UK. 9. BC Cancer, 600 W. 10th Avenue, Vancouver, BC, V5Z 4E1, Canada. 10. University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, Canada. 11. British Columbia Children's Hospital, 4480 Oak St, Vancouver, BC, V6H 3N1, Canada.
Abstract
INTRODUCTION: The study objectives were to describe patterns of practice for intracranial germ cell tumors (IGCT) in adolescents and young adults (AYA) and to determine factors associated with practice patterns. METHODS: A survey was written containing questions on the management of two 17-year old males, one with localized pineal germinoma and the other with localized pineal non-germinomatous germ cell tumor (NGGCT). An invitation to participate anonymously in the survey was e-mailed to 119 oncologists who treat brain tumors across Canada. RESULTS: Seventy-two (61%) of the 119 oncologists participated in the study. For the germinoma case, the most common treatment approaches were whole ventricular radiotherapy (WVRT) and chemotherapy (CH) (56%), WVRT alone (15%), and craniospinal radiotherapy (CSRT) alone (10%); for physicians recommending WVRT + CH, most frequently selected whole ventricular doses were 24 Gy (57%) and 18 Gy (20%). Chemotherapy was included in the treatment of germinoma by 96% of pediatric physicians vs. 54% of adult physicians (P = 0.001). The most common treatment approaches for NGGCT were CSRT + CH (44%), WVRT + CH (21%), and pineal gland RT + CH (15%). The selection of craniospinal vs. smaller-volume RT was not associated with the physicians' specialty, percentage of practice treating brain tumors, number of IGCTs seen, or size of institution. CONCLUSIONS: There is wide variation in the management of IGCT in AYA across Canada. A 17-year old male with a localized pineal germinoma is highly likely to receive chemotherapy if managed by a pediatric oncologist, while the same patient is much less likely to receive chemotherapy if managed by an adult oncologist.
INTRODUCTION: The study objectives were to describe patterns of practice for intracranial germ cell tumors (IGCT) in adolescents and young adults (AYA) and to determine factors associated with practice patterns. METHODS: A survey was written containing questions on the management of two 17-year old males, one with localized pineal germinoma and the other with localized pineal non-germinomatous germ cell tumor (NGGCT). An invitation to participate anonymously in the survey was e-mailed to 119 oncologists who treat brain tumors across Canada. RESULTS: Seventy-two (61%) of the 119 oncologists participated in the study. For the germinoma case, the most common treatment approaches were whole ventricular radiotherapy (WVRT) and chemotherapy (CH) (56%), WVRT alone (15%), and craniospinal radiotherapy (CSRT) alone (10%); for physicians recommending WVRT + CH, most frequently selected whole ventricular doses were 24 Gy (57%) and 18 Gy (20%). Chemotherapy was included in the treatment of germinoma by 96% of pediatric physicians vs. 54% of adult physicians (P = 0.001). The most common treatment approaches for NGGCT were CSRT + CH (44%), WVRT + CH (21%), and pineal gland RT + CH (15%). The selection of craniospinal vs. smaller-volume RT was not associated with the physicians' specialty, percentage of practice treating brain tumors, number of IGCTs seen, or size of institution. CONCLUSIONS: There is wide variation in the management of IGCT in AYA across Canada. A 17-year old male with a localized pineal germinoma is highly likely to receive chemotherapy if managed by a pediatric oncologist, while the same patient is much less likely to receive chemotherapy if managed by an adult oncologist.
Entities:
Keywords:
Adolescents and young adults; CNS; Germinoma; Intracranial germ cell tumor; Non-germinomatous; Pediatrics; Practice patterns; Survey
Authors: Kee Kiat Yeo; Darcy E Burgers; Katelynn Brodigan; Karen Fasciano; A Lindsay Frazier; Katherine E Warren; David A Reardon Journal: Neurooncol Pract Date: 2021-02-18