Treatment outcomes based on radiation therapy fields for bifocal germinoma: Synchronous or disseminated disease?

Autoři: Seung Yeun Chung aff001;  Jung Woo Han aff002;  Dong-Seok Kim aff003;  Hong In Yoon aff001;  Chang-Ok Suh aff004
Působiště autorů: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea aff001;  Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea aff002;  Department of Pediatric Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea aff003;  Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam-si, Gyeonggi-do, South Korea aff004
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article
doi: 10.1371/journal.pone.0223481


Intracranial germinoma sometimes present as bifocal germinoma, and whether bifocal germinoma should be treated as a synchronous or disseminated disease remains unclear. This study aimed to determine the optimal treatment modality for bifocal germinoma. Patients with bifocal germinoma who received radiotherapy (RT) from March 1990 to August 2017 were included for analysis. A total of 21 patients were included. The median follow-up period was 76.2 months (range, 6.2–305.4 months). There were 17 patients who received cranio-spinal irradiation (CSI) with local RT; 3, whole ventricular RT (WVRT) with local RT; and 1, local RT only. Three recurrences occurred (1 patient each among those who underwent CSI, WVRT, and local RT). Recurrence in the patient who received CSI and who received WVRT occurred in the right thalamus and right frontal convexity, respectively. Meanwhile, the patient who received local RT showed not only a recurred lesion in the hypothalamus, but also cerebrospinal fluid seeding. For this patient, salvage CSI was performed and complete response was achieved after treatment. However, after 9 years and 6 months, he was diagnosed with glioblastoma and expired. As for toxicity, although 17 patients showed decrease in complete blood count levels during treatment, all patients recovered soon after treatment completion. Our findings suggest that bifocal germinoma may be considered as a disseminated disease when considering the patterns of failure according to RT fields. In addition, patients who received CSI showed low acute toxicity rates. However, further studies are necessary to confirm these findings.

Klíčová slova:

Cancer chemotherapy – Cancer treatment – Lesions – Magnetic resonance imaging – Radiation therapy – Toxicity – Pineal gland – Disseminated diseases


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2019 Číslo 10