RARE-56. RECURRENCE PATTERN AND SURVIVAL FOR RELAPSED INTRACRANIAL NON-GERMINOMATOUS GERM CELL TUMORS: A SINGLE-INSTITUTION EXPERIENCE

Abstract

Abstract PURPOSE Intracranial non-germinomatous germ cell tumors (NGGCTs) have lower overall survival than germinoma because higher recurrence usually occurs after first line therapy in NGGCTs. METHODS Between January 2003 and December 2017, 23 patients with clinically or pathologically diagnosed recurrent NGGCTs after first line therapy were reviewed at our institution. Data of first line treatment, salvage treatment, clinicopathological features and survival were collected and analyzed. RESULTS First line therapy including craniospinal irradiation (CSI) in 15 patients, surgery in 3 patients, Gamma knife in 2 patients, chemotherapy in 2 patients and whole brain radiotherapy (WBRT) in 1 patient. The median time to recurrence was 13.8 months (5.8 to 89.2). With reference to the distribution of relapsed lesions, there were 8 patients within the primary site, 6 with distant intracranially, 1 ventricularly, 5 in spinal cords, 1 with dual sites in both primary site and intracranially, and 1 patient evidenced only serologically positive. Three patients did not receive further treatment and was lost during follow-up. Of the other patients, 16 patients received salvage chemotherapy with or without surgery, 4 received CSI or radiosurgery. After median follow up of 54 months, 7 patients died of disease progression. The 4-year overall survival rate after recurrence was 55.4%. CONCLUSION Protracted follow-up is recommended because late recurrence is not uncommon. Primary tumor site and distant intracranial are the most prevalent relapsed location. Patients who relapsed could benefited from salvage chemotherapy.