COMBINED TREATMENT WITH CHEMOTHERAPY AND RADIATION-THERAPY FOR INTRACRANIAL GERM-CELL TUMORS

We analyzed our treatment results in 153 patients with histologically verified intracranial germ cell tumors and proposed classifying them i nto three therapeutic groups with good prognosis, intermediate prognos is, and poor prognosis. In this work, we selected patients treated wit h chemotherapy (cisplatin or carboplatin combinations) in each subgrou p, and we discuss the role of chemotherapy in their treatment. Our com bination chemotherapy regimens are: cisplatin-vinblastine-bleomycin, c isplatin-etoposide, and carboplatin-etoposide. We delivered these chem otherapies to the last 33 patients and compared their treatment resul ts with those obtained in the previous 31 patients, who were treated w ith conventional radiation therapy alone. A combination with chemother apy and a reduced dose of irradiation with local field was given to 7 patients with germinoma to increase the cure rate and reduce radiation -induced side effects, including anterior pituitary dysfunction. We ob tained an excellent initial response to chemotherapy. The chemotherapy we delivered had significantly better effects in the group with inter mediate prognosis, but not in the group with poor prognosis. More aggr essive chemotherapy and radiation therapy should be given as the initi al treatment.