Treatment of intracranial nongerminomatous malignant germ cell tumor in children: the role of each treatment modality

To investigate the role of surgical tumor resection, radiotherapy and chemo therapy, the outcome of treatment in 17 children with non-germinomatous mal ignant germ cell tumor (NG-MGCT) was reviewed. The median follow-up period was 38 months after diagnosis, and the overall 3-year survival rate was 75% . Eleven patients who underwent craniospinal radiation (CSRT) did not recei ve chemotherapy. In 4 of them more than 90% of the tumor was removed, and t hey were free of disease at 16, 30, 93 and 111 months after surgery. Among the other 7, who did not undergo tumor resection (n=5) or had considerable residual tumor (n=2), 2 were disease-free at 73 and 88 months after diagnos is, and 5 died of recurrences. Of 6 patients who received cisplatin and eto poside chemotherapy in addition to CSRT, none showed intracranial recurrenc e, regardless of the extent of removal. The authors believe that multimodal treatment is the preferred choice and that chemotherapy plays an important role, especially when a significant amount of tumor remains after surgery. CSRT plays a major role at least in some patients. If chemotherapy is not feasible, radical removal plus CSRT seems to be an alternative.