CONCLUSIONS
Patients with DS treated for CNS GCTs are at an increased risk of
treatment-related death, particularly from treatment-related infection.
Based on our experience, we suggest that a different therapeutic
approach may be considered for this patient population in which
treatment intensity is reduced. To evaluate the long-term effects of RT
and chemotherapy in these patients, longer follow-up is needed. An
expanded multi-institutional analysis is warranted, as well as subgroup
specific analysis for DS patients within prospective clinical trials of
CNS GCTs.