지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2021.10
- 수록면
- 983 - 990 (8page)
- DOI
- 10.4143/crt.2020.1052
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초록· 키워드
오류제보하기
Purpose We aimed to refine the radiotherapy (RT) volume and dose for intracranial germinoma considering recurrences and long-term toxicities.
Materials and Methods Total 189 patients with intracranial germinoma were treated with RT alone (n=50) and RT with upfront chemotherapy (CRT) (n=139). All cases were confirmed histologically. RT fields comprised the extended-field and involved-field only for primary site. The extended-field, including craniospinal, whole brain (WB), and whole ventricle (WV) for cranial field, is followed by involved-field boost. The median follow-up duration was 115 months.
Results The relapses developed in 13 patients (6.9%). For the extended-field, cranial RT dose down to 18 Gy exhibited no cranial recurrence in 34 patients. In CRT, 74 patients (56.5%) showed complete response to chemotherapy and no involved-field recurrence with low-dose RT of 30 Gy. WV RT with chemotherapy for the basal ganglia or thalamus germinoma showed no recurrence. Secondary malignancy developed in 10 patients (5.3%) with a latency of 20 years (range, 4 to 26 years) and caused mortalities in six. WB or craniospinal field rather than WV or involved-field significantly increased the rate of hormone deficiencies, and secondary malignancy. RT dose for extended-field correlated significantly with the rate of hormone deficiencies, secondary malignancy, and neurocognitive dysfunction.
Conclusion De-intensifying extended-field rather than involved-field or total scheme of RT will be critical to decrease the late toxicities. Upfront chemotherapy could be beneficial for the patients with complete response to minimize the RT dose down to 30 Gy. Prospective trials focused on de-intensification of the extended-field RT are warranted.
목차
등록된 정보가 없습니다.
참고문헌 (20)
참고문헌 신청
도윤식 / 2017 / An Updated Nationwide Epidemiology of Primary Brain Tumors in Republic of Korea, 2013 / Brain Tumor Research and Treatment 5(1):16~23
이승훈 / 2017 / Nationwide Population-Based Incidence and Survival Rates of Malignant Central Nervous System Germ Cell Tumors in Korea, 2005-2012 / Cancer Research and Treatment 49(2):494~501
da Silva NS / 2010 / Primary chemotherapy for intracranial germ cell tumors : results of the third international CNS germ cell tumor study / Pediatr Blood Cancer 54:377~383
Byun HK / 2019 / Optimization of intracranial germinoma treatment : a single institution experience with 213 patients supports radiotherapy alone with reduced volume and dose / Int J Radiat Oncol Biology Phys 105:909
Lee DS / 2019 / Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma : prospective multicenter cohort study / Radiother Oncol 138:180~186
이승훈 / 2017 / Nationwide Population-Based Incidence and Survival Rates of Malignant Central Nervous System Germ Cell Tumors in Korea, 2005-2012 / Cancer Research and Treatment 49(2):494~501
da Silva NS / 2010 / Primary chemotherapy for intracranial germ cell tumors : results of the third international CNS germ cell tumor study / Pediatr Blood Cancer 54:377~383
Byun HK / 2019 / Optimization of intracranial germinoma treatment : a single institution experience with 213 patients supports radiotherapy alone with reduced volume and dose / Int J Radiat Oncol Biology Phys 105:909
Lee DS / 2019 / Upfront chemotherapy followed by response adaptive radiotherapy for intracranial germinoma : prospective multicenter cohort study / Radiother Oncol 138:180~186
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