Lei Wen1, Juan Li1, Mingyao Lai1, Zhaoming Zhou1,2, Qingjun Hu1, Guanhua Deng1, Changguo Shan1, Ruyu Ai1, Hainan Li3, Ming Lu4, Liang Zhang4, Taihua Wu4, Dan Zhu4, Yuanyuan Chen5, Longhua Chen6, Linbo Cai7, Cheng Zhou8. 1. Department of Oncology, Guangdong Sanjiu Brain Hospital, 510510, Guangzhou, China. 2. Department of Radiation Medicine, School of Public Health, Southern Medical University, Guangzhou, China. 3. Department of Pathology, Guangdong Sanjiu Brain Hospital, Guangzhou, China. 4. Department of Neurosurgery, Guangdong Sanjiu Brain Hospital, Guangzhou, China. 5. Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China. 6. Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China. 7. Department of Oncology, Guangdong Sanjiu Brain Hospital, 510510, Guangzhou, China. cailinbo999@163.com. 8. Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, China. czhou.rob@gmail.com.
Abstract
PURPOSE: This study aimed to evaluate the clinical features, prognostic factors, and survival outcomes for patients with intracranial nongerminomatous germ cell tumors (NGGCTs), with a particular focus on treatment toxicity for long-term survivors. METHODS: Intracranial NGGCTs treated with platinum-based chemotherapy and craniospinal irradiation (CSI) in our institution were retrospectively analyzed. Hematological complications following sequential chemoradiotherapy as well as height and weight in childhood survivors were evaluated. Plasma growth hormone (GH) concentrations prior to and after radiotherapy were obtained for the comparisons. RESULTS: A total of 111 intracranial NGGCTs were included. The 3‑year overall survival (OS) and event-free survival (EFS) rates were 83.5% ± 3.9% and 71.0% ± 4.8%, respectively. A combined treatment modality consisting of ≥ 4 cycles of platinum-based chemotherapy and CSI was associated with an improved OS (P = 0.003) and EFS (P < 0.001). Thrombocytopenia of any grade occurred in 35.4% (34/96) of patients, and the threshold age for an increased risk of thrombocytopenia was 14 years (area under the curve AUC = 0.752, P < 0.0001) as derived from receiver operating characteristic (ROC) analysis. Growth impediment was found in 8 of 56 (14%) patients. The age for receiving radiotherapy was found to inversely correlate with height development, revealing a cut-off age of 11.5 years for risking growth impairment (AUC = 0.806, P = 0.004). Consistently, a significant decline in plasma growth hormone after radiotherapy was observed in patients ≤ 11.5 years (P < 0.01) but not patients > 11.5 years. (P > 0.05). CONCLUSION: Our study suggested that a combined treatment modality with at least four cycles of chemotherapy and CSI was safe and effective for patients with intracranial NGGCTs. Radiotherapy should be used with caution for patients < 11.5 years due to growth impairment.
PURPOSE: This study aimed to evaluate the clinical features, prognostic factors, and survival outcomes for patients with intracranial nongerminomatous germ cell tumors (NGGCTs), with a particular focus on treatment toxicity for long-term survivors. METHODS: Intracranial NGGCTs treated with platinum-based chemotherapy and craniospinal irradiation (CSI) in our institution were retrospectively analyzed. Hematological complications following sequential chemoradiotherapy as well as height and weight in childhood survivors were evaluated. Plasma growth hormone (GH) concentrations prior to and after radiotherapy were obtained for the comparisons. RESULTS: A total of 111 intracranial NGGCTs were included. The 3‑year overall survival (OS) and event-free survival (EFS) rates were 83.5% ± 3.9% and 71.0% ± 4.8%, respectively. A combined treatment modality consisting of ≥ 4 cycles of platinum-based chemotherapy and CSI was associated with an improved OS (P = 0.003) and EFS (P < 0.001). Thrombocytopenia of any grade occurred in 35.4% (34/96) of patients, and the threshold age for an increased risk of thrombocytopenia was 14 years (area under the curve AUC = 0.752, P < 0.0001) as derived from receiver operating characteristic (ROC) analysis. Growth impediment was found in 8 of 56 (14%) patients. The age for receiving radiotherapy was found to inversely correlate with height development, revealing a cut-off age of 11.5 years for risking growth impairment (AUC = 0.806, P = 0.004). Consistently, a significant decline in plasma growth hormone after radiotherapy was observed in patients ≤ 11.5 years (P < 0.01) but not patients > 11.5 years. (P > 0.05). CONCLUSION: Our study suggested that a combined treatment modality with at least four cycles of chemotherapy and CSI was safe and effective for patients with intracranial NGGCTs. Radiotherapy should be used with caution for patients < 11.5 years due to growth impairment.
Authors: Stewart Goldman; Eric Bouffet; Paul G Fisher; Jeffrey C Allen; Patricia L Robertson; Paul J Chuba; Bernadine Donahue; Cynthia S Kretschmar; Tianni Zhou; Allen B Buxton; Ian F Pollack Journal: J Clin Oncol Date: 2015-06-22 Impact factor: 44.544
Authors: Winnie Wan Yee Tso; Anthony Pak Yin Liu; Tatia Mei Chun Lee; Ka Leung Cheuk; Ming Kong Shing; Chung Wing Luk; Siu Cheung Ling; Dennis Tak Loi Ku; Kenneth Li; Ada Wing Yan Yung; Cheuk Wing Fung; Sophelia Hoi Shan Chan; Alvin Chi Chung Ho; Frederick Ka Wing Ho; Patrick Ip; Godfrey Chi Fung Chan Journal: J Neurooncol Date: 2018-11-20 Impact factor: 4.130