Midline pineal tumors and suprasellar germinomas: highly curable by irradiation.

Sixty-one patients with midline pineal tumors and 16 patients with suprasellar germinomas were treated with surgical decompression and relatively high-dose radiotherapy of the primary site. Results were excellent, and there were no long-term complications. Ten per cent of midline pineal tumors and 37% of suprasellar germinomas metastasized to the cerebral or spinal subarachnoid space within 6 months to 5 years. Irradiation of the entire neural axis is recommended for locally extensive tumors, simultaneous pineal and hypothalamic lesions, and all biopsy-proved germinomas. The five-year survival rate was 79% for midline pineal tumors and 77% for suprasellar germinomas.