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Outcomes for pediatric patients with central nervous system germ cell tumors treated with proton therapy

PURPOSE: We assessed outcomes after proton therapy (PT) for central nervous system germinomas or non-germinomatous germ cell tumors (NGGCTs) in children. PATIENTS AND METHODS: We identified children with germ cell tumors of the central nervous system who received proton therapy in 2006–2009 and extr...

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Detalles Bibliográficos
Autores principales: Greenfield, Brad J., Jaramillo, Sergio, Abboud, Mirna, Mahajan, Anita, Paulino, Arnold C., McGovern, Susan, McAleer, Mary F., Chintagumpala, Murali, Okcu, M. Fatih, Khatua, Soumen, Su, Jack, Grosshans, David R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893478/
https://www.ncbi.nlm.nih.gov/pubmed/29657988
http://dx.doi.org/10.1016/j.ctro.2016.08.002
Descripción
Sumario:PURPOSE: We assessed outcomes after proton therapy (PT) for central nervous system germinomas or non-germinomatous germ cell tumors (NGGCTs) in children. PATIENTS AND METHODS: We identified children with germ cell tumors of the central nervous system who received proton therapy in 2006–2009 and extracted information on tumor response, treatment failures, and toxicity. RESULTS: Of the 20 identified patients (median age 12 years [range 3–16]), 9 had germinoma and 11 NGGCTs; 19 patients received three-dimensional conformal PT and 1 scanning-beam PT. Fourteen patients had craniospinal irradiation (CSI), 4 had ventricular irradiation that excluded the 4th ventricle, and 2 had whole-ventricle irradiation. All received involved-field boosts. At a median follow-up interval of 5.6 years (range, 0.3–8.2 years), 1 patient with germinoma had an out-of-field failure in the 4th ventricle and 2 with NGGCT died from disease progression after CSI. Rates of local control, progression-free survival, and overall survival at 5 years were 89%, 89%, and 100% for patients with germinoma; corresponding rates for NGGCTs were 82%, 82%, and 82%. The most common late toxicity (9 patients [45%]) was endocrinopathy. CONCLUSIONS: PT for CNS germ cell tumors is associated with acceptable disease control rates and toxicity profiles.