Treatment and Response
Treatment approaches are summarized in Table 3. Of the patients with germinomas (n=16), nine (56.3%) underwent surgical biopsy and seven (46.7%) underwent subtotal resection (STR). Ten patients (62.5%) received chemotherapy. All chemotherapies were platinum-based. Only one patient received chemotherapy alone. Of the patients who underwent combined chemotherapy/RT, all patients received chemotherapy prior to RT. Fourteen patients (87.5%) received RT; two patients (12.5%) received craniospinal irradiation (CSI) (mean 2370c Gy), three (18.8%) received whole brain radiotherapy (WBRT) (mean 29.3 Gy), four (25%) received whole ventricle irradiation (WVI) (mean 27 Gy), four (25%) received focal RT (mean 30 Gy) and one (6.3%) received an unspecified regimen. Four patients (25%) received primary site boost (mean total dose 43.3 Gy; three WVI, one CSI). Complete response (CR) was achieved in nine patients (56.3%) following therapy.
Of the patients with NGGCTs (n=16), five (31.3%) underwent surgical biopsy (three YSTs, one mixed GCT, one embryonal carcinoma), three (18.8%) underwent gross total resection (GTR) (two YSTs, one STGC) and four (25%) underwent STR (two YSTs, one embryonal carcinomas, one mixed GCT). Fifteen patients (93.4%) received chemotherapy; 10 (62.5%) received combined chemotherapy/RT (three YSTs, three mixed GCTs, one STGC, three unspecified) and four (25%) received chemotherapy-only (two YSTs, two embryonal carcinomas). All chemotherapies were platinum-based. One patient received no adjuvant therapy (one YST). Ten patients (62.5%) received RT; four (25%) received CSI (mean 22.5 Gy), two (12.5%) received WBRT (mean 25.5 Gy), one (6.3%) received WVI (dose unreported), two (12.5%) received focal RT (mean 45.6 Gy) and one (6.3%) received an unspecified regimen. Three patients (18.8%) received primary site boost (mean total dose 27 Gy). Complete response was achieved in 12 patients (75%) following therapy.
Of the patients with teratomas (n=8), three (37.5%) underwent surgical biopsy-only (one immature teratoma, two unspecified teratomas) and five (62.5%) underwent GTR (four immature teratomas, one mature teratoma). Adjuvant therapy was chemotherapy-only (three immature teratomas) or RT-only (one unspecified teratoma). All chemotherapy regimens were platinum-based. Five patients (62.5%) achieved CR following therapy.