ANALYSIS OF LONG-TERM TREATMENT OF INTRACRANIAL GERMINOMA

Purpose: To determine an appropriate treatment policy for intracranial germinoma. Methods and Materials: From 1976 to 1992, 51 patients with germinoma (18 with pathologically verified germinoma and 33 diagnosed as having germinoma by neuroimagings) were treated by radiation thera py. Various radiation doses and treatment fields were used. Results: T he 10-year cause-specific survival rate for pathologically verified an d unverified germinoma was 100% and 96%, respectively, Relapses were n oted in four patients, three of whom died from the disease. Two of the four patients with a tumor larger than 4 cm in gross diameter experie nced relapse. Two relapses occurred in a nonirradiated spinal canal an d two occurred in the irradiation area treated by 25 Gy in 10 fraction s and 30 Gy in 20 fractions, No relapse was noted in patients in whom the whole ventricle field was determined precisely using three-dimensi onal treatment planning, Five patients who were followed at an outpati ent clinic experienced significant late neurocognitive dysfunction, wh ich set in after radiotherapy. Conclusion: After pathological confirma tion, 40 Gy whole-ventricle irradiation using precise three-dimensiona l treatment planning is appropriate as a standard treatment for most i ntracranial germinoma. (C) 1997 Elsevier Science Inc.