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1. Yoo KH, Lee SH, Lee J, Sung KW, Jung HL, Koo HH, Lim DH, Kim JH, Shin HJ: Improved outcome of central nervous system germ cell tumors: implications for the role of risk-adapted intensive chemotherapy. J Korean Med Sci; 2010 Mar;25(3):458-65
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Improved outcome of central nervous system germ cell tumors: implications for the role of risk-adapted intensive chemotherapy.
  • To determine the impact of treatment protocols on the outcome of central nervous system germ cell tumors (CNS-GCTs), we reviewed the medical records of 53 patients who received front-line chemotherapy from September 1997 to September 2006.
  • Pure germinoma, normal alpha-fetoprotein level and beta-human chorionic gonadotropin level <50 mIU/mL were regarded as low-risk features and the others as high-risk.
  • Patients from different time periods were divided into 3 groups according to the chemotherapy protocols.
  • Group 1 (n=19) received 4 cycles of chemotherapy comprising cisplatin, etoposide and bleomycin.
  • Group 2 (n=16) and group 3 (n=18) received 4 cycles of chemotherapy with cisplatin, etoposide, cyclophosphamide and vincristine in the former and with carboplatin, etoposide, cyclophosphamide and bleomycin in the latter.
  • Radiotherapy was given after chemotherapy according to the clinical requirements.
  • Our data suggest that risk-adapted intensive chemotherapy may improve the outcome of patients with malignant CNS-GCTs.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy. Radiotherapy
  • [MeSH-minor] Adolescent. Biomarkers, Tumor / metabolism. Child. Combined Modality Therapy. Disease-Free Survival. Female. Humans. Kaplan-Meier Estimate. Male. Risk Factors. Treatment Outcome. Young Adult

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  • (PMID = 20191048.001).
  • [ISSN] 1598-6357
  • [Journal-full-title] Journal of Korean medical science
  • [ISO-abbreviation] J. Korean Med. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Korea (South)
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor
  • [Other-IDs] NLM/ PMC2826748
  • [Keywords] NOTNLM ; Central Nervous System / Drug Therapy / Neoplasms, Germ Cell and Embryonal / Survival
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2. Fujiwara K, Uenohara H, Suzuki H, Sakurai Y: Intracranial germinoma with syncytiotrophoblastic giant cells in the cerebellopontine angle--case report. Neurol Med Chir (Tokyo); 2002 Mar;42(3):132-6
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  • [Title] Intracranial germinoma with syncytiotrophoblastic giant cells in the cerebellopontine angle--case report.
  • Histological examination revealed that the tumor was a germinoma with syncytiotrophoblastic giant cells.
  • Whole central nervous system irradiation with cisplatin-etoposide chemotherapy was performed postoperatively.
  • Total surgical removal followed by irradiation and chemotherapy will provide a good outcome.
  • [MeSH-major] Cerebellar Neoplasms / surgery. Cerebellopontine Angle / surgery. Germinoma / surgery. Giant Cells
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Combined Modality Therapy. Craniotomy. Humans. Male. Radiotherapy, Adjuvant

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  • (PMID = 11936056.001).
  • [ISSN] 0470-8105
  • [Journal-full-title] Neurologia medico-chirurgica
  • [ISO-abbreviation] Neurol. Med. Chir. (Tokyo)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
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3. Kadota RP, Mahoney DH, Doyle J, Duerst R, Friedman H, Holmes E, Kun L, Zhou T, Pollack IF: Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma. Pediatr Blood Cancer; 2008 Nov;51(5):675-8
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  • [Title] Dose intensive melphalan and cyclophosphamide with autologous hematopoietic stem cells for recurrent medulloblastoma or germinoma.
  • PURPOSE: To determine the response, toxicity, and survival for children with progressive or recurrent medulloblastoma and germinoma using a single myeloablative course of chemotherapy supported by autologous hematopoietic stem cells.
  • PATIENTS AND METHODS: Subjects were in second remission or had minimal residual disease at the time of study entry.
  • There were 6 medulloblastoma and 3 germinoma survivors with a median follow-up of 7.5 years (range = 2.8-10).
  • Two germinoma survivors received radiotherapy after autografting for presumptive progressive disease.
  • CONCLUSION: Myeloablative chemotherapy consisting of cyclophosphamide and melphalan was tolerable in the relapsed brain tumor setting with 19/29 cases achieving CR or CCR status and 9/29 becoming long-term survivors.

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  • [Copyright] (c) 2008 Wiley-Liss, Inc.
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  • (PMID = 18623206.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / U10 CA098543-06; United States / NCI NIH HHS / CA / CA98543; United States / NCI NIH HHS / CA / U10 CA098413-06; United States / NCI NIH HHS / CA / U10 CA098413; United States / NCI NIH HHS / CA / U10 CA098543; None / None / / U10 CA098413-06; None / None / / U10 CA098543-06
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural
  • [Publication-country] United States
  • [Chemical-registry-number] 8N3DW7272P / Cyclophosphamide; Q41OR9510P / Melphalan
  • [Other-IDs] NLM/ NIHMS123029; NLM/ PMC2900925
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4. Jensen AW, Laack NN, Buckner JC, Schomberg PJ, Wetmore CJ, Brown PD: Long-term follow-up of dose-adapted and reduced-field radiotherapy with or without chemotherapy for central nervous system germinoma. Int J Radiat Oncol Biol Phys; 2010 Aug 1;77(5):1449-56
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  • [Title] Long-term follow-up of dose-adapted and reduced-field radiotherapy with or without chemotherapy for central nervous system germinoma.
  • PURPOSE: To update our institutional experience with neoadjuvant chemotherapy and minimized radiotherapy vs. radiation monotherapy for intracranial germinoma.
  • METHODS AND MATERIALS: We retrospectively reviewed records of 59 patients with diagnosis of primary intracranial germinoma between 1977 and 2007.
  • Treatment was irradiation alone or neoadjuvant platinum-based chemotherapy and local irradiation (initial tumor plus margin) for patients with localized complete response and reduced-dose craniospinal irradiation for others.
  • All were young male patients who received 30.6 Gy to local fields after complete response to chemotherapy.
  • Most patients in this group were young men 18 to 23 years of age with suprasellar primary disease treated with about 50 Gy to local fields.
  • CONCLUSIONS: The addition of neoadjuvant chemotherapy to local-field radiotherapy reduced central nervous system cancer recurrence when high-risk patients were excluded by thorough pretreatment staging.
  • There was trend toward improved central nervous system tumor control when larger fields (whole brain, whole ventricle, or craniospinal axis) were used.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Germinoma / drug therapy. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Analysis of Variance. Chemotherapy, Adjuvant / methods. Cisplatin / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Humans. Male. Neoadjuvant Therapy / methods. Neoplasm Recurrence, Local. Radiotherapy Dosage. Remission Induction / methods. Retrospective Studies. Survival Rate. Young Adult

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  • [Copyright] Copyright 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20045266.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
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5. Hsu YJ, Pai L, Chen YC, Ho CL, Kao WY, Chao TY: Extragonadal germ cell tumors in Taiwan: an analysis of treatment results of 59 patients. Cancer; 2002 Aug 15;95(4):766-74
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Extragonadal germ cell tumors in Taiwan: an analysis of treatment results of 59 patients.
  • More investigations are warranted to define the optimal treatment.
  • Primary tumors occurred in the mediastinum (n = 27), retroperitoneum (n = 6), central nervous system (CNS; n = 24), and other sites (n = 2).
  • Patients received surgery, chemotherapy, radiotherapy, or a combination of treatment modalities as the primary treatment.
  • Of 24 patients with intracranial germ cell tumors, 16 had germinoma and 13 (81%) achieved CR with NED at 8-228 months (median duration, 104 months).
  • Four of eight patients with CNS nongerminomas remain in CR and are alive with a median DFS period of 48 months.
  • Four patients with mediastinal nonsemonimas treated with salvage chemotherapy died.
  • CONCLUSIONS: The treatment results of our patients with seminomatous EGCT are comparable to those of Western countries.
  • However, the treatment results of patients with nonseminomatous EGCT are not as good.
  • The reason for this discrepancy needs to be explored for a better treatment outcome of for patients in Taiwan with EGCT.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Mediastinal Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy. Retroperitoneal Neoplasms / therapy
  • [MeSH-minor] Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Cisplatin / adverse effects. Cisplatin / therapeutic use. Combined Modality Therapy. Female. Germinoma / therapy. Humans. Infant. Male. Middle Aged. Retrospective Studies. Survival Analysis. Taiwan. Treatment Outcome

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  • [Copyright] Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10738
  • (PMID = 12209720.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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6. Calugaru V, Taillibert S, Lang P, Simon JM, Delattre JY, Mazeron JJ: [Neoadjuvant chemotherapy followed by radiotherapy adapted to the tumor response in the primary germinoma of the central nervous system: experience of the Pitié-Salpêtrière Hospital and review of literature]. Cancer Radiother; 2007 May;11(3):122-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Neoadjuvant chemotherapy followed by radiotherapy adapted to the tumor response in the primary germinoma of the central nervous system: experience of the Pitié-Salpêtrière Hospital and review of literature].
  • [Transliterated title] Chimiothérapie néoadjuvante suivie d'une radiothérapie adaptée à la réponse tumorale dans les tumeurs germinales séminomateuses du système nerveux central: expérience de l'hôpital de la Pitié-Salpêtrière et revue de la littérature.
  • PURPOSE: Retrospective analysis of ten cases of germinoma of the central nervous system treated in Pitié-Salpêtrière Hospital, Paris.
  • PATIENTS AND METHODS: Ten male patients were treated from 1997 to 2005 for histologically verified primary seminoma of the central nervous system.
  • Our option for the treatment was the association of 3-4 cycles of neoadjuvant chemotherapy (cisplatin and etoposide) to radiotherapy.
  • Five patients received a craniospinal radiotherapy of 30 Gy (for one patient 36 Gy) followed by a tumoral boost from 20 to 24 Gy.
  • For five patients, irradiated volume was limited to the tumour, total dose from 24 to 54 Gy (for three patients the total dose was from 24 to 30 Gy).
  • RESULTS: Six patients were in situation of complete remission after neoadjuvant chemotherapy.
  • CONCLUSION: In spite of the fact that the intracranial germinal tumours are not the subject of a consensual treatment strategy, this retrospective analysis pleads in favour of chemotherapy followed by limited dose and volume irradiation.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Germinoma / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Cisplatin / administration & dosage. Etoposide / administration & dosage. Humans. Male. Neoadjuvant Therapy. Radiotherapy Dosage. Radiotherapy, Adjuvant. Remission Induction. Retrospective Studies

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  • (PMID = 17459755.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin
  • [Number-of-references] 44
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7. Nguyen QN, Chang EL, Allen PK, Maor MH, Ater JL, Mahajan A, Wolff JE, Weinberg JS, Woo SY: Focal and craniospinal irradiation for patients with intracranial germinoma and patterns of failure. Cancer; 2006 Nov 1;107(9):2228-36
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  • [Title] Focal and craniospinal irradiation for patients with intracranial germinoma and patterns of failure.
  • BACKGROUND: The authors compared the patterns of failure in patients with intracranial germinoma who were managed with either chemotherapy and focal irradiation or with craniospinal irradiation (CSI).
  • METHODS: A retrospective review was conducted on 21 patients with intracranial germinoma and treated with radiotherapy (RT) to the central nervous system at The University of Texas M. D.
  • Nine patients received chemotherapy prior to focal RT.
  • CONCLUSIONS: Although focal techniques of irradiation with chemotherapy are attractive methods that limited the volume irradiated, the strategy appeared to be associated with increased rates of failures in the brain and spine.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Cranial Irradiation. Germinoma / radiotherapy. Spinal Cord / pathology. Spinal Neoplasms / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Child. Disease-Free Survival. Female. Humans. Male. Neoplasm Recurrence, Local. Radiotherapy, High-Energy. Retrospective Studies. Survival Rate. Treatment Failure

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  • [Copyright] (c) 2006 American Cancer Society.
  • (PMID = 17019739.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
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8. Sifat H, Haddadi K, el Ghazi E, Errihani H, Kamouni M, Mansouri H, Hassouni K, Bakkali H, Kanouni L, Gaye M, Kebdani T, Benjaafar N, el Gueddar BK: [Central nervous system germinoma: retrospective study of six cases]. Cancer Radiother; 2002 Sep;6(5):273-7
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  • [Title] [Central nervous system germinoma: retrospective study of six cases].
  • [Transliterated title] Les germinomes du système nerveux central: étude rétrospective de six cas.
  • PURPOSE: Retrospective analysis of six patients with intracranial germinoma treated in INO and a literature review.
  • MATERIALS AND METHODS: Six patients were treated from 1993 to 1998, for histologically verified primary intracranial germinoma.
  • All patients received chemo-radiotherapy (4FP + radiotherapy from 30 to 50 Gy).
  • One patient was lost to follow-up, 14 months after treatment, without disease.
  • CONCLUSION: The treatment of intracranial germinoma is currently first line chemotherapy followed by low-dose and limited irradiation.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Disease-Free Survival. Humans. Male. Radiotherapy Dosage. Retrospective Studies. Time Factors

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  • (PMID = 12412362.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] France
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9. Maruya J, Narita E, Nishimaki K, Heianna J, Miyauchi T, Minakawa T: Primary cystic germinoma originating from the midbrain. J Clin Neurosci; 2009 Jun;16(6):832-4
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  • [Title] Primary cystic germinoma originating from the midbrain.
  • A primary intracranial germinoma that involves the midbrain is rare.
  • We describe an unusual case of primary cystic germinoma originating from the midbrain.
  • Open biopsy was performed and the diagnosis of germinoma was based upon the histopathological findings.
  • Following chemotherapy and radiotherapy, the symptoms improved and the tumor disappeared.
  • We propose that primary intracranial germinoma should be included in the differential diagnosis of midbrain tumors, because early diagnosis and appropriate treatment for midbrain germinoma improves clinical outcome.
  • [MeSH-major] Brain Stem Neoplasms / pathology. Central Nervous System Cysts / pathology. Germinoma / pathology. Mesencephalon / pathology
  • [MeSH-minor] Adult. Antineoplastic Agents / administration & dosage. Biopsy. Carboplatin / administration & dosage. Diplopia / etiology. Etoposide / administration & dosage. Humans. Male. Radiotherapy. Treatment Outcome

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  • (PMID = 19299138.001).
  • [ISSN] 0967-5868
  • [Journal-full-title] Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia
  • [ISO-abbreviation] J Clin Neurosci
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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10. Grodman H, Wolfe L, Kretschmar C: Outcome of patients with recurrent medulloblastoma or central nervous system germinoma treated with low dose continuous intravenous etoposide along with dose-intensive chemotherapy followed by autologous hematopoietic stem cell rescue. Pediatr Blood Cancer; 2009 Jul;53(1):33-6
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  • [Title] Outcome of patients with recurrent medulloblastoma or central nervous system germinoma treated with low dose continuous intravenous etoposide along with dose-intensive chemotherapy followed by autologous hematopoietic stem cell rescue.
  • BACKGROUND: Adults and children with recurrent malignant central nervous system (CNS) tumors have a poor prognosis despite high dose chemotherapy with a conventional stem cell rescue regimen.
  • In this study we evaluated the results of low dose, continuous infusion etoposide over 21 days added to a conventional high-dose regimen of carboplatin and thiotepa in eight patients with relapsed pediatric CNS tumors.
  • PROCEDURE: Patients with high risk CNS tumors were treated with etoposide 25 mg/m(2)/day by continuous intravenous (IV) infusion from day -22 to day -2, carboplatin 667 mg/m(2)/dose IV (or area under the curve = 9 mg/ml/min according to the Calvert formula on days -8, -7, and -6, and thiotepa 300 mg/m(2)/dose IV on days -5, -4, and -3, followed by autologous hematopoietic stem cell rescue on day 0.
  • RESULTS: Eight adults and children, with a mean age of 12.9 years (age range 5.6-27.8 years), with relapsed primary CNS tumors (metastatic medulloblastoma (7), germinoma (1)), were enrolled.
  • This treatment strategy deserves further evaluation in a larger group of high-risk or relapsed primary CNS tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / therapy. Etoposide / administration & dosage. Germinoma / therapy. Hematopoietic Stem Cell Transplantation. Neoplasm Recurrence, Local / therapy
  • [MeSH-minor] Adolescent. Adult. Anemia / chemically induced. Anemia / therapy. Carboplatin / administration & dosage. Child. Child, Preschool. Female. Hematologic Diseases / chemically induced. Hematologic Diseases / therapy. Humans. Infusions, Intravenous. Male. Survival Rate. Thiotepa / administration & dosage. Treatment Outcome

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  • [Copyright] Copyright 2009 Wiley-Liss, Inc.
  • (PMID = 19326417.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 905Z5W3GKH / Thiotepa; BG3F62OND5 / Carboplatin
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11. Douglas JG, Rockhill JK, Olson JM, Ellenbogen RG, Geyer JR: Cisplatin-based chemotherapy followed by focal, reduced-dose irradiation for pediatric primary central nervous system germinomas. J Pediatr Hematol Oncol; 2006 Jan;28(1):36-9
Hazardous Substances Data Bank. CIS-DIAMINEDICHLOROPLATINUM .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cisplatin-based chemotherapy followed by focal, reduced-dose irradiation for pediatric primary central nervous system germinomas.
  • The objective of this study was to evaluate retrospectively one institution's experience treating pediatric central nervous system (CNS) pure germinomas with platinum-based chemotherapy followed by focal, reduced-dose irradiation.
  • Eight patients were identified with localized, pure CNS germinomas from 1993 to 2004 at the authors' institution.
  • Two patients suffered marginal (at field edge) failures and both were salvaged using reinduction platinum-based chemotherapy followed by cranial spinal irradiation and a boost to the primary tumor.
  • These data suggest that a reduction in both volume and dose (30.6-36 Gy) retains the excellent survival rates for patients with localized, pure germinomas of the CNS.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Cisplatin / administration & dosage. Germinoma / drug therapy. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Child. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Pituitary Gland / physiology. Radiation Dosage. Retrospective Studies. Salvage Therapy. Survival Rate. Treatment Outcome

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  • (PMID = 16394891.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; Q20Q21Q62J / Cisplatin
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12. Dietrich J, Marienhagen J, Schalke B, Bogdahn U, Schlachetzki F: Vascular neurotoxicity following chemotherapy with cisplatin, ifosfamide, and etoposide. Ann Pharmacother; 2004 Feb;38(2):242-6
Hazardous Substances Data Bank. IFOSFAMIDE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Vascular neurotoxicity following chemotherapy with cisplatin, ifosfamide, and etoposide.
  • OBJECTIVE: To report a case of acute central nervous system (CNS) toxicity with multiple hemorrhages restricted to the corpus callosum associated with combination therapy of cisplatin, ifosfamide, and etoposide.
  • CASE SUMMARY: A 38-year-old white man with a testicular germ cell tumor received a cisplatin-based chemotherapy consisting of cisplatin 45 mg (20 mg/m2), etoposide 570 mg (250 mg/m2), and ifosfamide 4600 mg (2000 mg/m2) given on 5 consecutive days during each course.
  • After the first course of chemotherapy, the patient appeared to be neuropsychologically impaired with episodes of decreased alertness and features of a depressive syndrome.
  • He became severely diminished in mental function, orientation, and psychomotor activity after a second course of treatment.
  • An objective causality assessment revealed that an adverse drug reaction was probable.
  • In particular, cisplatin and ifosfamide can cause both acute and delayed CNS toxicity.
  • To our knowledge, as of December 2, 2003, vascular lesions restricted to the corpus callosum have not been reported as a complication of cisplatin- or ifosfamide-based chemotherapy.
  • Chemotherapy-induced neurotoxicity should be considered in the differential diagnosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Intracranial Hemorrhages / chemically induced. Testicular Neoplasms / drug therapy
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Cisplatin / adverse effects. Corpus Callosum / radionuclide imaging. Etoposide / administration & dosage. Germinoma / drug therapy. Humans. Ifosfamide / administration & dosage. Magnetic Resonance Imaging. Male

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  • (PMID = 14742759.001).
  • [ISSN] 1060-0280
  • [Journal-full-title] The Annals of pharmacotherapy
  • [ISO-abbreviation] Ann Pharmacother
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
  • [Number-of-references] 29
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13. Shirato H, Aoyama H, Ikeda J, Fujieda K, Kato N, Ishi N, Miyasaka K, Iwasaki Y, Sawamura Y: Impact of margin for target volume in low-dose involved field radiotherapy after induction chemotherapy for intracranial germinoma. Int J Radiat Oncol Biol Phys; 2004 Sep 1;60(1):214-7
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  • [Title] Impact of margin for target volume in low-dose involved field radiotherapy after induction chemotherapy for intracranial germinoma.
  • The margin for initial gross tumor volume (GTV) before surgery and chemotherapy of the same materials was investigated by retrospective review.
  • The two-dimensional margin from the initial GTV to 90% of the prescribed dose of 24 Gy was 2.0 cm for a solitary lesion in the protocol.
  • The whole ventricle field was used for patients with multifocal disease and whole central nervous system field was used for disseminated disease, respectively.
  • No relapses were seen in the 9 patients who were treated with whole ventricle or whole central nervous system field.
  • The whole ventricle is recommended as the smallest target volume for germinoma with or without elevated HCG-beta after induction chemotherapy.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Chorionic Gonadotropin, beta Subunit, Human / blood. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Biomarkers, Tumor / blood. Child. Combined Modality Therapy. Humans. Neoplasm Recurrence, Local. Remission Induction. Retrospective Studies

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  • (PMID = 15337558.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human
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14. Silvani A, Eoli M, Salmaggi A, Lamperti E, Fariselli L, Milanesi I, Broggi G, Solero CL, Giombini S, Boiardi A: Combined chemotherapy and radiotherapy for intracranial germinomas in adult patients: a single-institution study. J Neurooncol; 2005 Feb;71(3):271-6
Hazardous Substances Data Bank. VINBLASTINE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Combined chemotherapy and radiotherapy for intracranial germinomas in adult patients: a single-institution study.
  • We report on our experience in the treatment of intracranial germinomas (18 pure germinomas and two germinomas with syncytiotrophoblastic giant cells) according to a strategy of radiotherapy doses and fields reduction after a neoadjuvant chemotherapy (Cisplatin-vinblastine and bleomycin combination).
  • Radiation therapy was delivered after the completion of the third and last course of chemotherapy.
  • For the solitary germinoma the target volume was the gross tumour volume.
  • In the five multifocal germinoma patients the whole ventricle volume was irradiated.
  • For the single disseminated germinoma patient we treated the whole central nervous system.
  • The cumulative doses were 30 Gy for the pure germinomas.
  • For the STGCs, a cumulative dose of 35 Gy was used.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Germinoma / drug therapy. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Antibiotics, Antineoplastic / administration & dosage. Bleomycin / administration & dosage. Chemotherapy, Adjuvant / methods. Cisplatin / administration & dosage. Combined Modality Therapy / methods. Female. Giant Cell Tumors / drug therapy. Giant Cell Tumors / therapy. Humans. Male. Middle Aged. Pineal Gland / pathology. Radiation Dosage. Survival Analysis. Treatment Outcome. Vinblastine / administration & dosage

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  • (PMID = 15735916.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antibiotics, Antineoplastic; 11056-06-7 / Bleomycin; 5V9KLZ54CY / Vinblastine; Q20Q21Q62J / Cisplatin
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15. Kamoshima Y, Sawamura Y: Update on current standard treatments in central nervous system germ cell tumors. Curr Opin Neurol; 2010 Dec;23(6):571-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Update on current standard treatments in central nervous system germ cell tumors.
  • PURPOSE OF REVIEW: Various approaches have been used for the management of patients with germ cell tumors (GCTs) in the central nervous system (CNS); however, the optimal treatment of both germinoma and nongerminomatous GCTs remains unknown.
  • This review discusses current management strategies and late effects of therapy for CNS GCTs.
  • RECENT FINDINGS: To reduce the late complications of radiation therapy for patients with germinoma, many investigators have introduced dose reduction of radiation therapy in association with platinum-based chemotherapy.
  • In addition, the radiation field has been restricted to the whole ventricular area for localized germinoma.
  • This type of combination therapy has shown promising results and preserves cognitive function and quality of life.
  • Despite various approaches including high-dose chemotherapy against highly malignant or relapsed GCTs, the prognoses of these patients remain dismal except for a few successful reports.
  • SUMMARY: The 10-year survival rate of CNS germinoma is approximately 90%.
  • Most patients with CNS GCTs are children and young adults.
  • Therefore, with the improving life prognosis of young patients, secondary neoplasms, secondary cerebral vasculopathy, neurocognitive deficits, and many other adverse effects induced by the initial treatments are problems to be solved in the next decade.
  • [MeSH-major] Antineoplastic Protocols / standards. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / radiotherapy
  • [MeSH-minor] Adolescent. Antineoplastic Agents / chemistry. Antineoplastic Agents / pharmacology. Antineoplastic Combined Chemotherapy Protocols / standards. Child. Germinoma / drug therapy. Germinoma / mortality. Germinoma / radiotherapy. Humans. Survival Rate / trends. Young Adult

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  • (PMID = 20885323.001).
  • [ISSN] 1473-6551
  • [Journal-full-title] Current opinion in neurology
  • [ISO-abbreviation] Curr. Opin. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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16. da Silva NS, Cappellano AM, Diez B, Cavalheiro S, Gardner S, Wisoff J, Kellie S, Parker R, Garvin J, Finlay J: Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell tumor study. Pediatr Blood Cancer; 2010 Mar;54(3):377-83
Hazardous Substances Data Bank. CYCLOPHOSPHAMIDE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell tumor study.
  • BACKGROUND: The treatment of central nervous system (CNS) germ cell tumors (GCT) remains controversial.
  • The purpose of this study was to demonstrate efficacy of a chemotherapy only strategy, with less morbidity, when compared to regimens with irradiation.
  • METHODS: Between January 2001 and December 2004 newly diagnosed patients with CNS GCT were treated with one of two risk-tailored chemotherapy regimens.
  • Twenty-five patients aged 4 months to 24.5 years were stratified: Regimen A consisted of 4-6 cycles of carboplatin/etoposide alternating with cyclophosphamide/etoposide for low risk (LR) localized germinoma with normal cerebrospinal fluid (CSF) and serum tumor markers.
  • Regimen B consisted of 4-6 cycles of carboplatin/cyclophosphamide/etoposide for intermediate-risk (IR) germinoma with positive human chorionic gonadotrophin-beta (HCGbeta) and/or CSF HCGbeta <50 mIU/ml and high-risk (HR) biopsy-proven non-germinomatous malignant elements (MMGCT) or elevated serum/CSF alpha-fetoprotein and/or HCGbeta serum/CSF >50 mIU/ml.
  • Seventeen (68%) patients achieved complete radiographic and marker responses after two courses and 19 (76%) after four courses of chemotherapy.
  • CONCLUSION: These intensive chemotherapy regimens proved less effective than irradiation containing regimens.
  • Our results indicate that, at the present time, standard treatment for CNS GCT continues to include irradiation either alone or combined with chemotherapy for pure germinomas and with chemotherapy for those with MMGCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Neoplasms, Germ Cell and Embryonal / drug therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / administration & dosage. Carboplatin / adverse effects. Child. Child, Preschool. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Female. Humans. Infant. Male. Treatment Outcome. Young Adult

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  • [Copyright] Copyright 2009 Wiley-Liss, Inc.
  • (PMID = 20063410.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; BG3F62OND5 / Carboplatin
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17. Tseng CK, Tsang NM, Wei KC, Jaing TH, Pai PC, Chang TC: Radiotherapy to primary CNS germinoma: how large an irradiated volume is justified for tumor control? J Neurooncol; 2003 May;62(3):343-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiotherapy to primary CNS germinoma: how large an irradiated volume is justified for tumor control?
  • Between 1990 and 1999, there were 30 primary central nervous system (CNS) germinoma patients who received radiotherapy (RT) as treatment.
  • The treatment field of RT included whole neuraxis in 10, whole brain in 8 and local tumor site in 12 patients; the median dose delivered to the whole neuraxis being 3060 cGy, with 3060 cGy to the whole brain and 5040 cGy to the tumor site.
  • Chemotherapy was prescribed in 9 patients.
  • The median time on follow-up for survivors is 73 months.
  • There were 7, out of a total of 30 patients, who suffered treatment failure.
  • Five of twelve patients (41.6%) who received partial brain RT failed in the brain, with no difference in the rate between patients with or without chemotherapy, and only 2 of 18 patients (11.1%) who received whole brain or whole neuraxis RT failed in the brain (p = 0.053).
  • In summary, partial brain RT will have higher probability of intracranial relapse, and sparing the spinal RT will not result in more spinal failure, whole brain RT would be sufficient for tumor control on primary CNS germinoma.
  • [MeSH-major] Central Nervous System Neoplasms / radiotherapy. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Female. Humans. Male. Prognosis. Radiotherapy Dosage. Survival Rate. Treatment Failure

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  • [Cites] J Neurosurg. 1998 Jan;88(1):66-72 [9420074.001]
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  • (PMID = 12777088.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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18. Ogino H, Shibamoto Y, Takanaka T, Suzuki K, Ishihara S, Yamada T, Sugie C, Nomoto Y, Mimura M: CNS germinoma with elevated serum human chorionic gonadotropin level: clinical characteristics and treatment outcome. Int J Radiat Oncol Biol Phys; 2005 Jul 1;62(3):803-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] CNS germinoma with elevated serum human chorionic gonadotropin level: clinical characteristics and treatment outcome.
  • PURPOSE: The prognostic significance of human chorionic gonadotropin (HCG) level in central nervous system germinoma remains controversial.
  • The purpose of this study was to compare clinical characteristics and prognosis of germinoma patients with normal and high HCG titers in the serum.
  • METHODS AND MATERIALS: We undertook a multi-institutional retrospective analysis of 103 patients with central nervous system germinoma whose serum HCG and/or beta-HCG level had been measured before treatment between 1984 and 2002.
  • All patients had been treated with radiation therapy either alone (n = 66) or in combination with chemotherapy (n = 37) with a median dose of 47.8 Gy.
  • Also, no other patient-, tumor-, or treatment-related factors seemed to influence the prognosis of the patients.
  • [MeSH-major] Central Nervous System Neoplasms / blood. Chorionic Gonadotropin / blood. Germinoma / blood. Neoplasm Proteins / blood
  • [MeSH-minor] Adolescent. Adult. Chorionic Gonadotropin, beta Subunit, Human / blood. Female. Humans. Male. Prognosis. Retrospective Studies. Survival Rate. Treatment Outcome

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  • (PMID = 15936563.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / Neoplasm Proteins
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19. Doolittle ND, Miner ME, Hall WA, Siegal T, Jerome E, Osztie E, McAllister LD, Bubalo JS, Kraemer DF, Fortin D, Nixon R, Muldoon LL, Neuwelt EA: Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjunction with osmotic opening of the blood-brain barrier for the treatment of patients with malignant brain tumors. Cancer; 2000 Feb 1;88(3):637-47
The Lens. Cited by Patents in .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjunction with osmotic opening of the blood-brain barrier for the treatment of patients with malignant brain tumors.
  • BACKGROUND: The aim of this study was to determine the safety and efficacy of intraarterial chemotherapy with osmotic opening of the blood-brain barrier (BBB) for the treatment of malignant brain tumors when administered across multiple centers.
  • METHODS: Patients with primary central nervous system lymphoma (PCNSL), primitive neuroectodermal tumor (PNET), germ cell tumor, cancer metastasis to the brain, or low or high grade glioma were eligible.
  • Prior to entry, magnetic resonance imaging or computed tomography brain scan, medical history, neurologic status, and Karnofsky performance status were reviewed at the coordinating center.
  • Between March 1994 and November 1997, 5 universities treated 221 adult patients with intraarterial chemotherapy with or without osmotic opening of the BBB (2464 procedures).
  • One patient with extensive glioma expired within 48 hours after treatment.
  • CONCLUSIONS: Using standard guidelines and protocols, intraarterial chemotherapy with or without osmotic opening of the BBB is feasible across multiple centers with a low incidence of catheter-related complications.
  • In patients with chemotherapy-sensitive tumors, such as PCNSL, PNET, germ cell tumor, and cancer metastasis to the central nervous system, enhanced delivery results in a high degree of tumor response, with an efficacy profile that is reproducible across multiple centers.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blood-Brain Barrier / drug effects. Brain Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Feasibility Studies. Female. Germinoma / drug therapy. Glioblastoma / drug therapy. Glioma / drug therapy. Humans. Injections, Intra-Arterial / adverse effects. Injections, Intra-Arterial / instrumentation. Karnofsky Performance Status. Lymphoma / drug therapy. Magnetic Resonance Imaging. Male. Middle Aged. Neuroectodermal Tumors / drug therapy. Neurologic Examination. Osmosis. Remission Induction. Reproducibility of Results. Safety. Tomography, X-Ray Computed

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  • [Copyright] Copyright 2000 American Cancer Society.
  • (PMID = 10649259.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA 31770; United States / NINDS NIH HHS / NS / R01 NS 33618; United States / NINDS NIH HHS / NS / R01 NS 34608
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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20. Kellie SJ, Boyce H, Dunkel IJ, Diez B, Rosenblum M, Brualdi L, Finlay JL: Primary chemotherapy for intracranial nongerminomatous germ cell tumors: results of the second international CNS germ cell study group protocol. J Clin Oncol; 2004 Mar 1;22(5):846-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Primary chemotherapy for intracranial nongerminomatous germ cell tumors: results of the second international CNS germ cell study group protocol.
  • PURPOSE: The optimum therapy for intracranial nongerminomatous germ cell tumors (NGGCT) remains controversial.
  • The primary objective of this study was to determine whether intensive cisplatin and cyclophosphamide-based combination chemotherapy was effective in patients with intracranial NGGCT.
  • Initial therapy included two courses of Regimen A (cisplatin, etoposide, cyclophosphamide, and bleomycin).
  • Those in CR after four courses of treatment received one additional course of Regimen A and Regimen B, while those not in CR after four treatment courses underwent second-look surgery and/or irradiation.
  • RESULTS: Sixteen of 17 patients assessable for response after two courses of treatment achieved a CR or partial response (CR + partial response, 0.94; 95% CI, 0.73 to 1.0).
  • With a median follow-up of 6.3 years, 14 of 20 patients are alive without disease; eight patients were without relapse or progression, of whom three received local irradiation in first complete remission in violation of protocol, and six patients were in durable second or third complete remission after further chemotherapy and/or irradiation.
  • CONCLUSION: Intensive chemotherapy was effective in one-third of patients in this study.
  • Salvage therapy, including irradiation, was feasible in patients with recurrent disease.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / pathology. Salvage Therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Child. Child, Preschool. Cisplatin / administration & dosage. Cohort Studies. Confidence Intervals. Cyclophosphamide / administration & dosage. Disease-Free Survival. Dose-Response Relationship, Drug. Drug Administration Schedule. Etoposide / administration & dosage. Female. Germinoma. Humans. Infusions, Intravenous. International Cooperation. Male. Middle Aged. Probability. Prognosis. Prospective Studies. Risk Assessment. Statistics, Nonparametric. Survival Analysis. Treatment Outcome

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  • (PMID = 14990640.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
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21. Weiner HL, Lichtenbaum RA, Wisoff JH, Snow RB, Souweidane MM, Bruce JN, Finlay JL: Delayed surgical resection of central nervous system germ cell tumors. Neurosurgery; 2002 Apr;50(4):727-33; discussion 733-4
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  • [Title] Delayed surgical resection of central nervous system germ cell tumors.
  • OBJECTIVE: To determine the value of delayed surgical resection in patients with central nervous system germ cell tumors who exhibit less than complete radiographic response despite declining serum and cerebrospinal fluid (CSF) tumor markers after initial chemotherapy.
  • METHODS: We retrospectively analyzed 126 patients enrolled on two international multicenter clinical trials (the First and Second International Central Nervous System Germ Cell Tumor Studies) for patients with newly diagnosed central nervous system germ cell tumors.
  • After at least three cycles of chemotherapy, 10 of these patients underwent delayed surgical resection owing to evidence of residual radiographic abnormalities despite declining or completely normalized serum and CSF levels of alpha-fetoprotein and human chorionic gonadotropin.
  • RESULTS: Eight of these patients demonstrated nongerminomatous germ cell tumor elements at the time of initial diagnosis.
  • After chemotherapy, radiographic evaluation revealed a partial response in seven patients, a minor response in one patient, and stable disease in two patients.
  • Pathological findings at second-look surgery demonstrated three patients to have mature teratomas, two with immature teratomas, and five with necrotic or scar tissue alone.
  • To date, 7 of the 10 patients have had no recurrence during an average follow-up time of 36.9 months (range, 3-96 mo).
  • Three of four patients with nongerminomatous germ cell tumors who had tumor markers that were decreased, but not normalized, before second-look surgery eventually developed tumor dissemination/progression, and they required subsequent radiation therapy despite having teratoma or necrosis/scar tissue at delayed surgery.
  • In contrast, three of four patients with nongerminomatous germ cell tumors and completely normalized markers did not progress and did not require radiation therapy.
  • CONCLUSION: Delayed surgical resection should be considered in patients with central nervous system germ cell tumors who have residual radiographic abnormalities and normalized tumor markers, because these lesions are likely to be teratoma or necrosis/scar tissue.
  • [MeSH-major] Central Nervous System Neoplasms / surgery. Germinoma / surgery
  • [MeSH-minor] Adolescent. Adult. Child. Clinical Trials as Topic. Humans. Male. Multicenter Studies as Topic. Retrospective Studies. Survival Analysis. Time Factors. Treatment Outcome

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  • [CommentIn] Neurosurgery. 2002 Dec;51(6):1530 [12484353.001]
  • (PMID = 11904022.001).
  • [ISSN] 0148-396X
  • [Journal-full-title] Neurosurgery
  • [ISO-abbreviation] Neurosurgery
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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22. Sakurada K, Saino M, Mouri W, Sato A, Kitanaka C, Kayama T: Nestin expression in central nervous system germ cell tumors. Neurosurg Rev; 2008 Apr;31(2):173-6; discussion 176-7

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Nestin expression in central nervous system germ cell tumors.
  • Central nervous system (CNS) germ cell tumors constitute a unique class of rare tumors that mainly affect children and adolescents.
  • Recently, results of treatment of germ cell tumors have improved with use of radiotherapy and combination chemotherapy.
  • However, some tumors have proven refractory to intensive treatment with surgery, radiation, and combination chemotherapy.
  • Nestin is an intermediate filament protein expressed in undifferentiated cells during CNS development and in CNS tumors and is used as a marker of immature elements of tumors, including brain tumor stem cells.
  • In this study, we examined for the first time nestin expression in 19 CNS germ cell tumors (nine pure germinomas, five germinomas with syncytiotrophoblastic giant cells, one yolk sac tumor, one choriocarcinoma, one embryonal carcinoma, and two mature teratomas).
  • These findings suggest that the detection of nestin expression could be useful in the management of CNS germ cell tumors, as an auxiliary predictor of dissemination and/or progression.
  • [MeSH-major] Biomarkers, Tumor / biosynthesis. Biomarkers, Tumor / genetics. Central Nervous System Neoplasms / genetics. Intermediate Filament Proteins / biosynthesis. Intermediate Filament Proteins / genetics. Neoplasms, Germ Cell and Embryonal / genetics. Nerve Tissue Proteins / biosynthesis. Nerve Tissue Proteins / genetics
  • [MeSH-minor] Adolescent. Adult. Child. Choriocarcinoma / genetics. Choriocarcinoma / metabolism. Choriocarcinoma / pathology. Endodermal Sinus Tumor / genetics. Endodermal Sinus Tumor / metabolism. Endodermal Sinus Tumor / pathology. Female. Germinoma / genetics. Germinoma / metabolism. Germinoma / pathology. Giant Cell Tumors / genetics. Giant Cell Tumors / metabolism. Giant Cell Tumors / pathology. Humans. Hypopituitarism / etiology. Immunoenzyme Techniques. Magnetic Resonance Imaging. Male. Nestin. Teratoma / genetics. Teratoma / metabolism. Teratoma / pathology. Vision Disorders / etiology

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  • (PMID = 18092184.001).
  • [ISSN] 0344-5607
  • [Journal-full-title] Neurosurgical review
  • [ISO-abbreviation] Neurosurg Rev
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Intermediate Filament Proteins; 0 / NES protein, human; 0 / Nerve Tissue Proteins; 0 / Nestin
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23. Khatua S, Dhall G, O'Neil S, Jubran R, Villablanca JG, Marachelian A, Nastia A, Lavey R, Olch AJ, Gonzalez I, Gilles F, Nelson M, Panigrahy A, McComb G, Krieger M, Fan J, Sposto R, Finlay JL: Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation. Pediatr Blood Cancer; 2010 Jul 15;55(1):42-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation.
  • BACKGROUND: The purpose of this study was to evaluate a reduced irradiation dose strategy for newly diagnosed primary central nervous system (CNS) germinomas.
  • METHODS: Twenty patients with histologically diagnosed localized pure germinoma (n = 19) or germinoma with a mature teratoma component (n = 1) received four cycles of carboplatin and etoposide at 3-week intervals.
  • In 18 patients, chemotherapy was followed by whole ventricular irradiation to 21.6-25.5 Gy with a simultaneous integrated or sequential primary site boost to 30-30.6 Gy.
  • Neurocognitive function was evaluated periodically following treatment.
  • CONCLUSION: Chemotherapy followed by reduced dose whole ventricular and local boost irradiation appears to be effective in patients with localized pure CNS germinoma with evidence of preservation of neurocognitive function.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / therapy. Central Nervous System Neoplasms / therapy. Germinoma / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Adult. Carboplatin / adverse effects. Carboplatin / therapeutic use. Child. Child, Preschool. Chorionic Gonadotropin, beta Subunit, Human / blood. Combined Modality Therapy. Dose-Response Relationship, Radiation. Etoposide / adverse effects. Etoposide / therapeutic use. Female. Humans. Infant. Magnetic Resonance Imaging. Male. Retrospective Studies. Young Adult. alpha-Fetoproteins / analysis

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  • (PMID = 20222020.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin
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24. Kamoshima Y, Sawamura Y, Ikeda J, Shirato H, Aoyama H: Late recurrence and salvage therapy of CNS germinomas. J Neurooncol; 2008 Nov;90(2):205-11

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Late recurrence and salvage therapy of CNS germinomas.
  • Central nervous system (CNS) germinoma is a curable tumor and its recurrence rate after initial therapy may be approximately 10% or higher.
  • This study elucidates the time-course of recurrence and results of salvage therapy.
  • Twenty-five patients with recurrent germinoma treated at Hokkaido University Hospital were retrospectively reviewed.
  • The median age at initial treatment was 12 years (range: 8-37).
  • All patients had been tumor-free for at least 6 months after the initial treatment.
  • The median age at first recurrence was 18 years and the median time to the first recurrence was 50 months.
  • The latest recurrence in a patient occurred 230 months after the initial treatment.
  • The results of salvage therapy were estimated in all 25 patients.
  • At first recurrence, 11 patients were treated using radiation therapy with or without surgery and 7 out of the 11 patients died due to the recurrent tumor.
  • On the other hand, 13 patients who received salvage chemotherapy and radiotherapy were tumor-free at the last follow-up.
  • In conclusion, late recurrence is not a rare event in patients with CNS germinoma.
  • As a salvage therapy, platinum-based chemotherapy followed by wide-field low-dose radiation therapy appears to be effective.
  • [MeSH-major] Central Nervous System Neoplasms / prevention & control. Germinoma / prevention & control. Salvage Therapy / methods
  • [MeSH-minor] Adolescent. Adult. Child. Female. Follow-Up Studies. Humans. Male. Remission Induction. Retrospective Studies. Secondary Prevention. Time Factors. Young Adult

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  • (PMID = 18604473.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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25. Wong LC, Yang TL, Gao F, Tan AM, Sethi VK, Chua EJ: Intracranial germ cell tumour: experience of a Singaporean institution over 11-year period. Singapore Med J; 2002 Apr;43(4):182-8

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • We present our experience in Therapeutic Radiology Department, National Cancer Centre, Singapore.
  • The tumours were mainly pineal germinoma (72%).
  • Four to six cycles of BEP or JEB chemotherapy (CM) were given in 10 patients.
  • The germinoma group had 75% 10-year OS and 86% 10-year RFS.
  • Mixed germinoma and non-germinoma germ cell tumours (NGGCT) group had 50% one-year RFS and 44% two-year OS.
  • There was no statistically significant difference in side-effects when treatment modalities were compared.
  • CONCLUSION: In the treatment of intracranial germinoma, we recommend biopsy and CSRT.
  • Primary chemotherapy (+/- low-dose cranial RT) should be used in the protocol or clinical trial settings.
  • Chemo-radiotherapy is recommended for mixed germinoma and NGGCT.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Germinoma / therapy
  • [MeSH-minor] Adolescent. Adult. Child. Combined Modality Therapy. Female. Humans. Male. Retrospective Studies. Singapore. Survival Analysis. Treatment Outcome

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  • (PMID = 12188062.001).
  • [ISSN] 0037-5675
  • [Journal-full-title] Singapore medical journal
  • [ISO-abbreviation] Singapore Med J
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Singapore
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26. Nakazaki K, Titoku S, Ota S, Sato M, Kobanawa S, Tutida K, Tanaka Y, Goto K, Ota T: [Lacunar infarction in brain tumor patients: chronic stage complication after radiation therapy]. No Shinkei Geka; 2007 Oct;35(10):1019-23
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  • [Title] [Lacunar infarction in brain tumor patients: chronic stage complication after radiation therapy].
  • The authors reported two relatively young adults with lacunar infarction that took place many years after radiation therapy.
  • This patient had received radiation therapy and chemotherapy for a right basal ganglia germinoma when he was 24 years old.
  • The patient had received radiation therapy for a suprasellar tumor when she was 11 years old.
  • Review of the literature was made and the possibility of radiation therapy as a causative factor of the lacunar infarction in relatively young adults was discussed.
  • [MeSH-major] Brain Infarction / etiology. Brain Neoplasms / radiotherapy. Germinoma / radiotherapy. Hemangioma, Cavernous, Central Nervous System / radiotherapy. Radiotherapy / adverse effects
  • [MeSH-minor] Adult. Age Factors. Female. Humans. Magnetic Resonance Imaging. Male. Time Factors

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  • (PMID = 17969339.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
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27. Hartmann JT, Nichols CR, Droz JP, Horwich A, Gerl A, Fossa SD, Beyer J, Pont J, Kanz L, Einhorn L, Bokemeyer C: Prognostic variables for response and outcome in patients with extragonadal germ-cell tumors. Ann Oncol; 2002 Jul;13(7):1017-28
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • BACKGROUND: This investigation evaluates prognostic variables in patients with seminomatous and non-seminomatous extragonadal germ-cell tumors (EGCT) in order to identify relevant factors for long-term outcome following cisplatin-based chemotherapy.
  • Uni- and multivariate analyses of prognostic variables for survival and for response to chemotherapy were performed.
  • For non-seminomatous EGCT the following independent adverse factors were identified: presence of either liver, lung or central nervous system metastases, primary mediastinal tumor or elevation of pretreatment beta-human gonadotropin; for extragonadal seminoma (only univariate) adverse factors were: presence of liver metastases, two or greater metastatic sites or International Germ Cell Cancer Collaborative Group (IGCCCG) grouping (intermediate versus good).
  • Multivariate testing for the probability to respond to chemotherapy revealed non-seminomatous histology, primary mediastinal tumor site, and the presence of liver, lung or CNS metastases as independent adverse factors.
  • CONCLUSIONS: In EGCT, prognostic variables for the outcome and for the response to chemotherapy could be identified, which in part differ from gonadal GCT.
  • The proposed model might help to better understand the specific prognosis of EGCT and to tailor risk-adapted treatment strategies.

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  • (PMID = 12176779.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins
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28. Merchant TE, Gould CJ, Xiong X, Robbins N, Zhu J, Pritchard DL, Khan R, Heideman RL, Krasin MJ, Kun LE: Early neuro-otologic effects of three-dimensional irradiation in children with primary brain tumors. Int J Radiat Oncol Biol Phys; 2004 Mar 15;58(4):1194-207
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  • PURPOSE: Central nervous system (CNS) irradiation can cause sensorineural hearing loss.
  • Conformal radiation therapy (CRT) techniques facilitate accurate cochlear dosimetry.
  • We modeled hearing threshold levels (HTL) after CRT in children with localized primary brain tumors (ependymoma, low- or high-grade astrocytoma, craniopharyngioma, or CNS germinoma) by using cochlear dose and clinical variables.
  • We used a mixed-effects model to predict change in hearing for each ear as a function of time, cochlear dose, and clinical variables.
  • RESULTS: Hearing was affected the greatest in patients with CSF shunts and pre-CRT ototoxic chemotherapy, enhanced by cochlear dose, and was more prominent on the right side.
  • Hearing impairment after CRT alone occurred at low and intermediate frequencies in patients with shunts and supratentorial tumors when the cochlear dose exceeded 32 Gy.
  • Patients with shunts and central supratentorial tumors developed intermediate-frequency hearing loss after CRT alone regardless of dose.
  • CSF shunting and increased cochlear dose enhance the effect of ototoxic chemotherapy.
  • If possible, the average cochlear dose should be <32 Gy over a 6-week course of treatment until more specific dose data become available.
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Audiometry. Child. Child, Preschool. Female. Follow-Up Studies. Hearing Loss, Sensorineural / etiology. Humans. Male. Radiotherapy Dosage

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  • (PMID = 15001264.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R25 CA023944; United States / NCI NIH HHS / CA / P30 CA 21765
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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29. Fujimaki T, Mishima K, Asai A, Tabuchi K, Kobayashi M, Suzuki I, Kirino T: Levels of beta-human chorionic gonadotropin in cerebrospinal fluid of patients with malignant germ cell tumor can be used to detect early recurrence and monitor the response to treatment. Jpn J Clin Oncol; 2000 Jul;30(7):291-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Levels of beta-human chorionic gonadotropin in cerebrospinal fluid of patients with malignant germ cell tumor can be used to detect early recurrence and monitor the response to treatment.
  • BACKGROUND: Tumor marker-producing germ cell tumors of the central nervous system are malignant and require radiation and/or chemotherapy.
  • Although serum beta-human chorionic gonadotropin (hCG) has been used to monitor the course of treatment, the levels of beta-hCG in the cerebrospinal fluid (CSF) have not been measured routinely in the clinic.
  • To determine whether they can be used to evaluate parameters of tumor status, such as progression or response to therapy, levels of beta-hCG in the serum and CSF of patients with germ cell tumors were studied.
  • Beta-hCG was negative in both serum and CSF in 11 instances and the levels in the other 43 paired samples were analyzed for any correlation or relationship to therapy.
  • In all the paired samples except for one time point, the level in CSF was higher than that in serum.
  • Among cases of recurrent malignant germ cell tumor, there were nine instances of recurrence or progression despite therapy.
  • CONCLUSION: It seems likely that the level of beta-hCG in CSF is a good marker for monitoring tumor recurrence or evaluation of treatment results.
  • [MeSH-major] Brain Neoplasms / diagnosis. Cerebrospinal Fluid / chemistry. Chorionic Gonadotropin, beta Subunit, Human / analysis. Germinoma / diagnosis
  • [MeSH-minor] Adolescent. Adult. Child. Humans. Male. Neoplasm Recurrence, Local

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  • (PMID = 11007160.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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30. Timmerman RD, Patel D, Boaz JC, Goldman J, Jakacki RI: Patterns of failure after induction chemotherapy followed by consolidative radiation therapy for children with central nervous system germinoma. Med Pediatr Oncol; 2003 Dec;41(6):564-6
COS Scholar Universe. author profiles.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Patterns of failure after induction chemotherapy followed by consolidative radiation therapy for children with central nervous system germinoma.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Cranial Irradiation. Germinoma / drug therapy. Germinoma / radiotherapy. Registries / statistics & numerical data
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Combined Modality Therapy. Databases, Factual. Disease Progression. Female. Follow-Up Studies. Humans. Male. Neoplasm Recurrence, Local

  • Genetic Alliance. consumer health - Germinoma.
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  • (PMID = 14595717.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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