caa a22 4500 463180240 CHVBK 20180406164837.0 cr unu---uuuuu 170326e20071001xx s 000 0 eng 10.1007/s00381-007-0394-6 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0394-6 Treatment failure in intracranial primary germinomas [Elektronische Daten] [Kyu-Won Shim, Tae-Gon Kim, Chang-Ok Suh, Jae-Ho Cho, Chul-Joo Yoo, Joong-Uhn Choi, Jung-Hee Kim, Dong-Seok Kim] Object: A radiation dose of 40-50Gy is able to produce a cure rate of more than 90% in intracranial pure germinoma. However, many attempts have been made to reduce the dose and volume of radiation without compromising the disease control rate because of the toxicity of irradiation. This retrospective study is intended to provide the physician with an appropriate therapeutic strategy. Materials and methods: We reviewed a series of 10 recurrent germinomas among 117 germinomas diagnosed histologically or clinically between 1979 and 2002. These patients involved underwent three different treatment modalities; radiation alone (N = 71), chemotherapy alone (N = 9), and combined therapy (N = 37). The 10-year overall and relapse-free survival rates were 97 and 93% in the radiation alone group, 89 and 67% in the chemotherapy alone group, and 92 and 92% in the combined therapy group, respectively. As expected, both radiation therapy and combined therapy were effective in controlling the disease. Tumor recurrence was closely related to the volume of radiation but not to the dose of radiation. If the tumor bed and craniospinal axis were fully covered, the radiation dose might be reduced. Chemotherapy alone showed earlier recurrence and a higher tumor recurrence rate. In the case of combined therapy, chemotherapy was useful in reducing the radiation dose but revealed some toxicity (death of two patients). Conclusions: The investigation of a possible further dose reduction seems worthwhile. Radiation therapy alone with a dose of less than 40Gy should be compared with ongoing chemotherapeutic protocols combined with low-dose irradiation. Springer-Verlag, 2007 Germinoma nationallicence Recurrence nationallicence Radiation nationallicence Chemotherapy nationallicence Shim Kyu-Won Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Kim Tae-Gon Department of Neurosurgery, Pochon CHA University College of Medicine, Seongnam, Korea aut Suh Chang-Ok Department of Radio-oncology, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Cho Jae-Ho Department of Radio-oncology, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Yoo Chul-Joo Department of Pediatrics, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Choi Joong-Uhn Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Kim Jung-Hee Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Kim Dong-Seok Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut Child's Nervous System Springer-Verlag 23/10(2007-10-01), 1155-1161 0256-7040 23:10<1155 2007 23 381 https://doi.org/10.1007/s00381-007-0394-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0394-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Shim Kyu-Won Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Kim Tae-Gon Department of Neurosurgery, Pochon CHA University College of Medicine, Seongnam, Korea aut NATIONALLICENCE 700 1- Suh Chang-Ok Department of Radio-oncology, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Cho Jae-Ho Department of Radio-oncology, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Yoo Chul-Joo Department of Pediatrics, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Choi Joong-Uhn Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Kim Jung-Hee Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 700 1- Kim Dong-Seok Department of Neurosurgery, Brain Korea 21 Project for Medical Science, Brain research institute, Yonsei University College of Medicine, Seoul, South Korea aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/10(2007-10-01), 1155-1161 0256-7040 23:10<1155 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer