NONGERMINOMATOUS GERM-CELL TUMORS OF THE BRAIN

Purpose: This analysis was performed to determine the clinical outcome of patients with primary nongerminomatous germ cell tumors of the bra in. The efficacy of various treatment options was evaluated. Methods a nd Materials: A total of 57 patients with primary nongerminomatous ger m cell tumors of the brain were identified. Patient-related data were collected and analyzed retrospectively. Follow-up in surviving patient s ranged from 3 to 243 months (median follow-up 36). Survival and fail ure rates were determined using the Kaplan-Meier method, and differenc es between the survival curves were evaluated using either the log ran k test or the Wilcoxon test. Results: The 3-year survival rate was 86% for patients with mature teratomas, 67% for patients with immature te ratomas, 44% for patients with mixed germ cell tumors, and 13% for pat ients with the other histologic types (p = 0.02). The 3-year survival rate was 0% for patients having biopsies alone, 32% for patients havin g subtotal resections, and 73% for patients having gross total resecti ons (p = 0.0001). Patients with tumors other than mature or immature t eratomas were evaluated for possible relationships between the adminis tration of chemotherapy or radiotherapy and survival. Patients who rec eived chemotherapy had a 3-year survival rate of 56% compared to 8% fo r those patients who did not receive chemotherapy (p = 0.0001) Patient s who received radiotherapy had a 3-year survival rate of 46% compared to 11% for those patients who did not receive radiotherapy (p = 0.001 5). Conclusion: The survival of patients with primary nongerminomatous germ cell tumors of the brain is dependent on tumor histology and the extent of surgical resection. Patients with tumors other than mature or immature teratomas appear to benefit from the administration of che motherapy and radiotherapy. Copyright (C) 1996 Elsevier Science Inc.