P05.06 * INTRACRANIAL GERMINOMA IN CHILDREN-SINGLE INSTITUTIONAL EXPERIENCE

Abstract

PURPOSE: The aim of our study is to evaluate results of treatment and to develop optimized treatment in children with Germinoma of Central nervous system (CNS). METHOD: Between 2001 and 2013., in Institute for Oncology and Radiology of Serbia we treated 9 patients with CNS Germinoma. The patients median age was 13 years (range 8 -18 yrs), and the male to female ratio was 8:1. A solitary tumor was found in pineal region (3 pts), in region ventriculi III and region supraselaris (2 pts), in one patient in region thalami, in one patient in region mesencephalon and 1 patient has leptomeningeal dissemination. Two patients had elevated B_HCG level in cerebrospinal fluid. After surgery (6 biopsy and 3 gross total resection) all patients received the boost to the primary tumor bed with additional prophylactic therapy to the craniospinal axis. Three patients (33,3 %) were treated with radiotherapy only and six pts (66,7%) were treated by using multimodal therapeutic approach including chemotherapy and radiotherapy. Two patients were treated according to SIOP GSCT trial - both achieved complete response (CR) after neoadjuvant chemotherapy. After irradiation patient with disseminated disease had also no residual tumor and afterwards he received 4 cycles of PEI regimen. One patient received 4 cycles of PEI regimen, also with complete response, followed by irradiation; one patient received only 2 cycles of SIOP GSCT regimen after irradiation (because of hematological toxicity); one patient received 1 cycle of PEI regimen, followed by irradiation and due to chematological toxicity, 3 cycles of Carboplatinum, Etoposid. RESULTS: All patients, treated either with radiotherapy or with radio and chemotherapy, remained disease free during the 20 to 146 months follow-up period (Me= 50 months). CONCLUSION: Results indicate that intracranial germinoma are highly radio and chemosensitive tumors. These excellent results suggest that ongoing trials are needed so to optimize treatment strategy in an effort to minimize late effects of therapy.