Y. Itoyama et al., TREATMENT OF INTRACRANIAL NONGERMINOMATOUS MALIGNANT GERM-CELL TUMORSPRODUCING ALPHA-FETOPROTEIN, Neurosurgery, 36(3), 1995, pp. 459-464
WE TREATED 10 patients with intracranial nongerminomatous malignant ge
rm cell tumors producing alpha-fetoprotein between 1969 and 1992. Two
patients were treated with radiotherapy (RT) only (RT group), and thre
e were treated with RT and cisplatin plus vinblastine plus bleomycin t
herapy with or without surgery (cisplatin plus vinblastine plus bleomy
cin group). The most recently treated five patients received cisplatin
plus etoposide (PE) therapy with or without RT and/or surgery (PE gro
up). The level of alpha-fetoprotein in serum was elevated in all 10 pa
tients. In the PE group, PE therapy consisted of cisplatin (20 mg/m(2)
) and etoposide (60 mg/m(2)) daily for 5 days (one course) given two t
o three times at 4-week intervals and then once every 4 months; the pa
tients received three to six courses (mean, 4.2 courses). In the RT gr
oup (n = 2), one patient died 3 months after diagnosis and the other d
ied at 12 months. In the cisplatin plus vinblastine plus bleomycin gro
up (n = 3), complete remission was obtained in one. patient, but the o
ther two patients died 12 and 24 months after diagnosis. In contrast,
in the PE group (n = 5), complete remission was obtained in all patien
ts who are all currently alive without recurrence, at 35 to 71 months
(average, 53.6 mo) after diagnosis. The results indicate that multidis
ciplinary treatment including combination chemotherapy with cisplatin
and etoposide with or without surgery and/or RT is highly effective in
the treatment of patients with alpha-fetoprotein-producing intracrani
al nongerminomatous malignant germ cell tumor.