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1. Reddy AT, Wellons JC 3rd, Allen JC, Fiveash JB, Abdullatif H, Braune KW, Grabb PA: Refining the staging evaluation of pineal region germinoma using neuroendoscopy and the presence of preoperative diabetes insipidus. Neuro Oncol; 2004 Apr;6(2):127-33
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  • [Title] Refining the staging evaluation of pineal region germinoma using neuroendoscopy and the presence of preoperative diabetes insipidus.
  • Treatment strategies for CNS germinoma are currently evolving.
  • Current approaches include reducing the volume and dose of radiation by adding pre-irradiation chemotherapy.
  • Eight consecutive patients with pineal germinoma at one institution underwent endoscopic surgery for tumor biopsy, direct visualization of the third ventricular region, and third ventriculostomy for those with hydrocephalus.
  • All patients were treated with 4 cycles of chemotherapy.
  • Conformal field radiation therapy followed, with the dose to the tumor bed dependent on the response to chemotherapy.
  • All patients have completed therapy and are alive, with no evidence of disease at median follow-up of 31.5 months from diagnosis.
  • [MeSH-major] Diabetes Insipidus / pathology. Germinoma / pathology. Neuroendoscopy / methods. Pinealoma / pathology

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  • (PMID = 15134627.001).
  • [ISSN] 1522-8517
  • [Journal-full-title] Neuro-oncology
  • [ISO-abbreviation] Neuro-oncology
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Other-IDs] NLM/ PMC1871986
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2. 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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  • [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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3. Bokemeyer C, Schleucher N, Metzner B, Thomas M, Rick O, Schmoll HJ, Kollmannsberger C, Boehlke I, Kanz L, Hartmann JT: First-line sequential high-dose VIP chemotherapy with autologous transplantation for patients with primary mediastinal nonseminomatous germ cell tumours: a prospective trial. Br J Cancer; 2003 Jul 7;89(1):29-35
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  • [Title] First-line sequential high-dose VIP chemotherapy with autologous transplantation for patients with primary mediastinal nonseminomatous germ cell tumours: a prospective trial.
  • To determine the efficacy of first-line sequential high-dose VIP chemotherapy (HD-VIP) in patients with primary mediastinal nonseminomatous germ cell tumours (GCT), 28 patients were enrolled on a German multicentre trial.
  • High-Dose VIP chemotherapy consisted of 3-4 cycles of dose-intensive etoposide and ifosfamide plus cisplatin, q22days, each cycle followed by autologous peripheral blood stem cell transplantation plus granulocyte-colony stimulating factor (G-CSF) support.
  • Ten patients had mediastinal involvement as the only manifestation (36 %), 18 of 28 patients had additional metastatic sites, such as lung (n=17; 61%), liver (n=7; 25%), bone (n=5; 18%), lymph nodes (n=3; 11%) and CNS (n=3; 11%).
  • Two patients developed recurrence of GCT or teratoma.
  • Compared to data of an international database analysis including 253 patients with mediastinal nonseminoma treated with conventional chemotherapy, the results may indicate that HD-VIP results in an approximately 15% survival improvement.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy. Mediastinal Neoplasms / drug therapy. Peripheral Blood Stem Cell Transplantation
  • [MeSH-minor] Adult. Cisplatin / administration & dosage. Combined Modality Therapy. Disease-Free Survival. Etoposide / administration & dosage. Female. Granulocyte Colony-Stimulating Factor / administration & dosage. Humans. Ifosfamide / administration & dosage. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Prospective Studies. Treatment Outcome

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  • (PMID = 12838296.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study
  • [Publication-country] England
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; ICE protocol 1
  • [Other-IDs] NLM/ PMC2394224
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4. Kretschmar C, Kleinberg L, Greenberg M, Burger P, Holmes E, Wharam M: Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children's Oncology Group. Pediatr Blood Cancer; 2007 Mar;48(3):285-91
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  • [Title] Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children's Oncology Group.
  • BACKGROUND: This Phase II study was designed to determine response to chemotherapy and survival after response-based radiation (RT) in children with CNS germ cell tumors.
  • PROCEDURE: Children with germinomas and normal markers received cisplatin 100 mg/m(2) + etoposide, alternating with vincristine + cyclophosphamide (CPM) 2 g/m(2)/d, for four cycles.
  • For germinoma patients in complete response (CR), RT was decreased from 50.4 to 30.6 Gy.
  • High-risk patients received neuraxis RT: 50.4 Gy local + 30.6 Gy neuraxis in CR; 54 Gy local + 36 Gy if less than CR.
  • RESULTS: Of 12 germinoma patients, 4 had cerebrospinal fluid (CSF) human chorionic gonadotropin (HCG) 6.9-21 mIU/ml.
  • Four germinoma patients attained CR, six PR, one SD, one not evaluable after resection.
  • Eleven germinoma patients are PF at median 66 months; one patient in CR refused RT, had PD at 10 months, received RT, and was PF at 56 months.
  • CONCLUSION: Response (germinoma, 91%; nongerminomatous, 55%) and survival are encouraging after this regimen plus response-based RT.

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  • (PMID = 16598761.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / P30 CA006973
  • [Publication-type] Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ NIHMS582771; NLM/ PMC4086720
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5. 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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6. Shibamoto Y: Management of central nervous system germinoma: proposal for a modern strategy. Prog Neurol Surg; 2009;23:119-29
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of central nervous system germinoma: proposal for a modern strategy.
  • With the development of diagnostic, radiologic, and therapeutic modalities, strategies for management of central nervous system (CNS) germinoma are changing gradually.
  • The author advocates that typical germinomas can be diagnosed based on their typical clinical and radiological findings, together with slight elevation of beta-human chorionic gonadotropin levels in the serum and/or cerebrospinal fluid (CSF) and quick response to radiation or chemotherapy.
  • Radiation therapy has been the standard treatment for CNS germinoma until recently.
  • Germinomas 4 cm or less in diameter can be cured with radiation doses of 40-45 Gy.
  • Regarding the treatment volume, an individualized approach is recommended and a focal radiation field covering at least major parts of the ventricular system is recommended if no CSF dissemination is present and CSF cytology is negative.
  • Such irradiation is best given by intensity-modulated radiation therapy.
  • Systemic chemotherapy with reduced doses (24-30 Gy) of radiation has to some extent been successful, but longer follow-up periods are necessary to draw conclusions regarding the superiority of this treatment over standard-dose radiation therapy.
  • CNS germinoma patients should be completely cured with minimum morbidity, probably by employing appropriate doses of chemotherapy and intensity-modulated radiation therapy in the future.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Germinoma / radiotherapy. Pineal Gland. Pinealoma / radiotherapy

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  • [Copyright] Copyright (c) 2009 S. Karger AG, Basel.
  • (PMID = 19329866.001).
  • [ISSN] 0079-6492
  • [Journal-full-title] Progress in neurological surgery
  • [ISO-abbreviation] Prog Neurol Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 37
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7. 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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8. 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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9. 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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  • [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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  • (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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10. Merchant TE, Sherwood SH, Mulhern RK, Rose SR, Thompson SJ, Sanford RA, Kun LE: CNS germinoma: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. Int J Radiat Oncol Biol Phys; 2000 Mar 15;46(5):1171-6
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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: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation.
  • PURPOSE: To provide evidence that radiation therapy alone in the form of craniospinal irradiation (CSI) and a boost to the primary site of disease provides effective disease control and limited additional morbidity for patients with CNS germinoma.
  • METHODS AND MATERIALS: Twelve patients with a median age of 12 years (range 9-16 years) with CNS germinoma were treated with CSI (median 25.6 Gy, range 23.4-32 Gy) and a boost to the primary site of disease (50.4 Gy, range 45-54 Gy) between January 1987 and June 1998.
  • All patients were biopsied prior to radiation therapy and none received chemotherapy.
  • CONCLUSIONS: This study confirms the ability of radiation therapy alone to achieve disease control with a high rate of success in pediatric patients and demonstrates that the treatment toxicity faced by these patients may be less than anticipated.
  • Because these patients present with substantial preexisting morbidity at diagnosis and may be of an age where the potential for radiation-related side effects is relatively small, the superiority of treatment alternatives may be difficult to prove.
  • [MeSH-major] Brain Neoplasms / radiotherapy. Cranial Irradiation. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Body Height. Child. Endocrine System / radiation effects. Female. Follow-Up Studies. Humans. Male. Neuropsychological Tests. Pinealoma / blood. Pinealoma / radiotherapy. Radiotherapy Dosage

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  • (PMID = 10725628.001).
  • [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] 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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11. Si SJ, Khatua S, Dhall G, Nelson MD, Gonzalez-Gomez I, Finlay JL: Regression of primary central nervous system germinoma after dexamethasone administration: a case report. Pediatr Hematol Oncol; 2010 Apr;27(3):237-43
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Regression of primary central nervous system germinoma after dexamethasone administration: a case report.
  • Childhood central nervous system (CNS) germinoma are highly curable brain tumors characterized pathologically by varying degrees of lymphocytic infiltration.
  • The authors present a case of a CNS germinoma with significant regression in size following surgery and administration of dexamethasone, prior to initiation of chemotherapy or irradiation.
  • Perioperative corticosteroid administration in patients with CNS germinoma may obfuscate the increase in response demonstrated with various chemotherapy regimens or with irradiation in CNS germinomas.
  • [MeSH-major] Brain Neoplasms / drug therapy. Dexamethasone / therapeutic use. Germinoma / drug therapy

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  • (PMID = 20367268.001).
  • [ISSN] 1521-0669
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 7S5I7G3JQL / Dexamethasone
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12. 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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13. 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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14. 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
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  • [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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15. Balmaceda C: Chemotherapy for intramedullary spinal cord tumors. J Neurooncol; 2000 May;47(3):293-307

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Chemotherapy for intramedullary spinal cord tumors.
  • Intramedullary tumors are rare, accounting for only about 4% of all CNS neoplasms.
  • Although surgery represents the most effective treatment, recurrence may occur.
  • As a large proportion of intramedullary malignancies occur in children, who are more sensitive to the deleterious effects of irradiation, chemotherapy assumes an important role.
  • This article describes the most common intramedullary tumors and the role of chemotherapy.
  • [MeSH-major] Astrocytoma / drug therapy. Ependymoma / drug therapy. Germinoma / drug therapy. Spinal Cord Neoplasms / drug therapy
  • [MeSH-minor] Adult. Child. Genetic Therapy. Humans. Neuroectodermal Tumors, Primitive / therapy. Prognosis

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  • (PMID = 11016745.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 82
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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
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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 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. Aoyama T, Hida K, Ishii N, Seki T, Ikeda J, Iwasaki Y: Intramedullary spinal cord germinoma--2 case reports. Surg Neurol; 2007 Feb;67(2):177-83; discussion 183
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intramedullary spinal cord germinoma--2 case reports.
  • BACKGROUND: Primary intramedullary spinal cord germinoma is very rare.
  • We encountered 2 patients with primary intramedullary spinal cord germinoma.
  • We describe herein our comprehensive management system for CNS germinoma, including intramedullary spinal cord germinoma, along with a review of the literature.
  • This is the first report to describe successful application of ICE chemotherapy for intramedullary germinoma.
  • However, pathologic examination identified germinoma.
  • Successful treatment with ICE chemotherapy and radiotherapy was implemented, with no evidence of recurrence apparent at 48 months postoperatively.
  • Because the lesion did not respond to steroid pulse therapy, spinal cord tumor was suspected and biopsy was performed.
  • Pathologic examination verified primary germinoma of the spine.
  • Successful treatment with ICE chemotherapy and radiotherapy was implemented with no exacerbation of neurologic deficits.
  • CONCLUSION: Correct diagnosis of very rare primary intramedullary spinal cord germinoma is important, because these patients can be treated successfully using chemo- and radiotherapy without neurologic deterioration.
  • [MeSH-major] Germinoma / diagnosis. Germinoma / therapy. Spinal Cord / pathology. Spinal Cord Neoplasms / diagnosis. Spinal Cord Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Combined Chemotherapy Protocols. Biomarkers, Tumor / analysis. Biomarkers, Tumor / metabolism. Chorionic Gonadotropin, beta Subunit, Human / analysis. Chorionic Gonadotropin, beta Subunit, Human / metabolism. Female. Humans. Magnetic Resonance Imaging. Neurosurgical Procedures. Paraparesis / etiology. Radiotherapy. Treatment Outcome. Urination Disorders / etiology

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  • (PMID = 17254883.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human
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18. Matsutani M, Japanese Pediatric Brain Tumor Study Group: Combined chemotherapy and radiation therapy for CNS germ cell tumors--the Japanese experience. J Neurooncol; 2001 Sep;54(3):311-6
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  • [Title] Combined chemotherapy and radiation therapy for CNS germ cell tumors--the Japanese experience.
  • Among intracranial germ cell tumors, nongerminomatous tumors have proved refractory to conventional treatment with surgery and irradiation.
  • Since 1983, chemotherapy has been delivered in Japan as an adjuvant therapy in patients with intracranial nongerminomatous germ cell tumors.
  • Based on our clinical experience, we undertook a multi-institutional phase II study to establish post-surgical combined chemotherapy and radiation therapy for primary germ cell tumors in the brain.
  • We adopted carboplatin-etoposide (CARB-VP) or cisplatin-etoposide (PE) combination chemotherapy for patients with germinomas and those with tumors that placed them in the intermediate prognosis group, and ifosphamide-cisplatin-etoposide (ICE) for patients with tumors that placed them in the poor prognosis group.
  • Among patients with germinoma (n = 75), the rate or complete remission after combination therapy was 92.0%; it was 67.8% for patients in the intermediate prognosis group (n = 28).
  • Tumor recurrence was noted in 9 patients with germinoma and 2 patients in the intermediate prognosis group.
  • Of 9 patients with a poor prognosis, 4 experienced disease progression during treatment and died within 10 months.
  • There were no serious complications attributable to the combination therapy.
  • Our treatment protocols are effective for patients with germinomas and those with an intermediate prognosis.
  • [MeSH-major] Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Germinoma / drug therapy. Germinoma / radiotherapy. Postoperative Care. Teratoma / drug therapy. Teratoma / radiotherapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Humans. Neoplasm Recurrence, Local. Prognosis. Remission Induction

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  • (PMID = 11767296.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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19. 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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20. 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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21. 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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22. 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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23. Kellie SJ, Boyce H, Dunkel IJ, Diez B, Rosenblum M, Brualdi L, Finlay JL: Intensive cisplatin and cyclophosphamide-based chemotherapy without radiotherapy for intracranial germinomas: failure of a primary chemotherapy approach. Pediatr Blood Cancer; 2004 Aug;43(2):126-33
Hazardous Substances Data Bank. CYCLOPHOSPHAMIDE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Intensive cisplatin and cyclophosphamide-based chemotherapy without radiotherapy for intracranial germinomas: failure of a primary chemotherapy approach.
  • More recently, similar results have been reported with chemotherapy combined with radiotherapy to more localized treatment volumes.
  • Our interest in exploring chemotherapy without radiotherapy in patients with CNS germinomas was based on concerns about the late sequelae of radiotherapy to the brain or neuraxis and also the well documented success of chemotherapy alone in patients with disseminated extracranial germinomas.
  • The primary objective of this study was to determine whether intensive cisplatin and cyclophosphamide-based combination chemotherapy, without radiotherapy, was effective in patients with CNS germinomas.
  • Therapy comprised two courses of Regimen 'A' (cisplatin, etoposide, cyclophosphamide, and bleomycin) followed by MRI evaluation.
  • Patients achieving a complete remission (CR) completed all planned therapy with two courses of regimen 'B' (carboplatin, etoposide, 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 radiation therapy.
  • Three patients died from treatment-related toxicity and another died in CR 1 from an uncharacterized leukoencephalopathy.
  • CONCLUSIONS: Intensive cisplatin and cyclophosphamide-based chemotherapy was effective in achieving remissions, however, the long-term outcome using this treatment program was unsatisfactory and associated with unacceptable morbidity and mortality, particularly in patients with diabetes insipidus.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Germinoma / drug therapy


24. Modak S, Gardner S, Dunkel IJ, Balmaceda C, Rosenblum MK, Miller DC, Halpern S, Finlay JL: Thiotepa-based high-dose chemotherapy with autologous stem-cell rescue in patients with recurrent or progressive CNS germ cell tumors. J Clin Oncol; 2004 May 15;22(10):1934-43
Hazardous Substances Data Bank. THIO-TEPA .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Thiotepa-based high-dose chemotherapy with autologous stem-cell rescue in patients with recurrent or progressive CNS germ cell tumors.
  • PURPOSE: To evaluate the efficacy and toxicity of high-dose chemotherapy (HDC) followed by autologous stem-cell rescue (ASCR) in patients with relapsed or progressive CNS germ cell tumors (GCTs).
  • PATIENTS AND METHODS: Twenty-one patients with CNS GCTs who experienced relapse or progression despite having received initial chemotherapy and/or radiotherapy were treated with thiotepa-based HDC regimens followed by ASCR.
  • Seven of nine (78%) patients with germinoma survived disease-free after HDC with a median survival of 48 months.
  • Patients with germinoma fared better than those with NGGCTs (P =.016 and.014 for OS and EFS, respectively).
  • CONCLUSION: Dose escalation of chemotherapy followed by ASCR is effective therapy for patients with recurrent CNS germinomas and might be effective in patients with recurrent NGGCTs with a low tumor burden.
  • [MeSH-major] Antineoplastic Agents, Alkylating / administration & dosage. Brain Neoplasms / therapy. Germinoma / therapy. Hematopoietic Stem Cell Transplantation. Neoplasm Recurrence, Local / therapy. Thiotepa / administration & dosage
  • [MeSH-minor] Adolescent. Adult. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Male. Medical Records. New York. Retrospective Studies. Salvage Therapy. Survival Analysis. Treatment Outcome

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  • (PMID = 15143087.001).
  • [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] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Alkylating; 905Z5W3GKH / Thiotepa
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25. Tscherry G, Jacky E, Jost LM, Stahel RA: Risk-adapted chemotherapy of germ cell tumors with carboplatin, etoposide and bleomycin for low-risk and cisplatin, etoposide and ifosfamide for high-risk patients. A single-center study. Oncology; 2000 Aug;59(2):110-7
Hazardous Substances Data Bank. CARBOPLATIN .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Risk-adapted chemotherapy of germ cell tumors with carboplatin, etoposide and bleomycin for low-risk and cisplatin, etoposide and ifosfamide for high-risk patients. A single-center study.
  • The prognosis of germ cell tumors treated with chemotherapy depends on the presence of nonseminomatous tumor, clinical parameters based on the tumor volume and site, as well as on the level of the tumor markers AFP, betaHCG and LDH.
  • We report here on the results of a risk-adapted approach to the chemotherapy of germ cell tumors.
  • Patients with low-risk tumors, defined as seminomatous disease and/or nonseminomatous disease with a tumor mass <10 cm, less than 20 lung metastases, no liver, bone, or CNS metastases, and levels of AFP <1,000 IU/ml and betaHCG <10,000 IU/l, were to receive 4 cycles of carboplatin 400 mg/m(2) i.v. day 1, etoposide 120 mg/m(2) i.v. days 1-3 and bleomycin 30 IU i.v. days 1, 8 and 15 during the first 3 cycles (CEB(90)).
  • Four patients with CR relapsed between 4 to 8 months after the start of chemotherapy.
  • Of the 6 patients failing CEB(90), 3 were treated successfully with surgery or further chemotherapy.
  • All 3 patients failing VIP had successful salvage therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Germinoma / drug therapy
  • [MeSH-minor] Adolescent. Adult. Bleomycin / administration & dosage. Bleomycin / adverse effects. Carboplatin / administration & dosage. Carboplatin / adverse effects. Cisplatin / administration & dosage. Cisplatin / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Follow-Up Studies. Humans. Ifosfamide / administration & dosage. Ifosfamide / adverse effects. Middle Aged. Risk Factors. Treatment Outcome

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  • [Copyright] Copyright 2000 S. Karger AG, Basel.
  • (PMID = 10971168.001).
  • [ISSN] 0030-2414
  • [Journal-full-title] Oncology
  • [ISO-abbreviation] Oncology
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; BG3F62OND5 / Carboplatin; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; ICE protocol 1; JEB protocol
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26. 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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27. Klein O, Voirin J, Civit T, Auque J, Marchal JC: Germinoma located in the basal ganglia in an 8-year-old girl. Childs Nerv Syst; 2007 Jan;23(1):105-8
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  • [Title] Germinoma located in the basal ganglia in an 8-year-old girl.
  • CASE REPORT: The authors describe a unique case of an 8-year-old girl with a germinoma located in the left basal ganglia.
  • Medical history begins 5 months before with a central diabetes insipidus, loss of weight (5 kg at admission), vomiting and asthenia.
  • Computed tomography (CT) and cranial magnetic resonance imaging (MRI) are performed and demonstrate a left basal ganglia tumour (nucleus lentiformis).
  • Diabetes insipidus is considered as non-visible germinoma localization on the pituitary stalk rather than as a possible consequence of peri-tumoural oedema surrounding the hypothalamus.
  • DISCUSSION: The first hypothesis is low-grade glioma, but pathological examination following a stereotactic biopsy of the lesion reveals a cerebral germinoma.
  • A few days before the biopsy, the girl experienced a mild left facial palsy, and CT scans at the time of biopsy reveals an intra-tumoural haemorrhage.
  • Dedicated chemotherapy, followed by focal irradiation (40 Gy, 30 sessions, 45 days; SIOP CNS GCT 93 protocol), is performed with a complete response.
  • [MeSH-major] Basal Ganglia / pathology. Brain Neoplasms / pathology. Brain Neoplasms / physiopathology. Germinoma / pathology. Germinoma / physiopathology
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Asthenia / etiology. Child. Combined Modality Therapy. Diabetes Insipidus / etiology. Diagnosis, Differential. Female. Glioma / pathology. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Radiotherapy. Tomography, X-Ray Computed. Vomiting / etiology. Weight Loss

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  • (PMID = 17058090.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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28. Hadziahmetovic M, Clarke JW, Cavaliere R, Mayr NA, Montebello JF, Grecula JC, Newton HB, Chang EL, Lo SS: CNS germinomas: what is the best treatment strategy? Expert Rev Neurother; 2008 Oct;8(10):1527-36
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] CNS germinomas: what is the best treatment strategy?
  • CNS germ cell tumors are rare primary brain malignancies.
  • Germinomas comprise approximately two-thirds of CNS germ cell tumors.
  • Owing to their radiosensitivity, radiotherapy has been used to treat patients with CNS germinomas, with favorable treatment outcomes.
  • Given the concerns over long-term toxicities associated with craniospinal irradiation, reduced volume radiotherapy with or without chemotherapy has been employed.
  • Data on the use of different strategies in the treatment of CNS germinomas are emerging but a standard strategy has not been established.
  • This article reviews the different strategies used in the management of CNS germinomas.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Brain Neoplasms / therapy. Germinoma / therapy. Neurosurgical Procedures / trends. Practice Patterns, Physicians' / trends. Radiotherapy / trends
  • [MeSH-minor] Combined Modality Therapy / methods. Humans

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  • (PMID = 18928345.001).
  • [ISSN] 1744-8360
  • [Journal-full-title] Expert review of neurotherapeutics
  • [ISO-abbreviation] Expert Rev Neurother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 61
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29. Schmoll HJ, Kollmannsberger C, Metzner B, Hartmann JT, Schleucher N, Schöffski P, Schleicher J, Rick O, Beyer J, Hossfeld D, Kanz L, Berdel WE, Andreesen R, Bokemeyer C, German Testicular Cancer Study Group: Long-term results of first-line sequential high-dose etoposide, ifosfamide, and cisplatin chemotherapy plus autologous stem cell support for patients with advanced metastatic germ cell cancer: an extended phase I/II study of the German Testicular Cancer Study Group. J Clin Oncol; 2003 Nov 15;21(22):4083-91
Hazardous Substances Data Bank. IFOSFAMIDE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Long-term results of first-line sequential high-dose etoposide, ifosfamide, and cisplatin chemotherapy plus autologous stem cell support for patients with advanced metastatic germ cell cancer: an extended phase I/II study of the German Testicular Cancer Study Group.
  • PURPOSE: Patients with disseminated germ cell cancer and poor prognosis (International Germ Cell Cancer Collaborative Group [IGCCCG] classification) achieve only a 45% to 50% long-term survival by standard chemotherapy.
  • First-line high-dose chemotherapy might be able to improve the result.
  • PATIENTS AND METHODS: Between July 1993 and November 1999, 221 patients with either Indiana "advanced disease" (n = 39) or IGCCCG "poor prognosis" criteria (n = 182) received one cycle of VIP followed by three to four sequential cycles of high-dose VIP chemotherapy plus stem cell support, every 3 weeks, at six consecutive dose levels.
  • RESULTS: Dose limiting toxicity occurred at level 8 (100 mg/m2 cisplatinum, 1750 mg/m2 etoposide, 12 g/m2 ifosfamide) with grade 4 mucositis (three of eight patients), grade 3 CNS toxicity (one of eight patients), grade 4 renal toxicity (one of eight patients), and prolonged granulocytopenia (one of eight patients).
  • Severe toxicity included treatment related death (4%), treatment-related acute myeloid leukemia (1%), long-term impared renal function (3%), chronic renal failure (1%), and persistent grade 2-3 neuropathy (5%).
  • An ongoing randomized trial within the European Organization for Research and Treatment of Cancer evaluates this protocol against four cycles of standard cisplatin, etoposide, and bleomycin.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cisplatin / administration & dosage. Etoposide / administration & dosage. Germinoma / therapy. Hematopoietic Stem Cell Transplantation. Ifosfamide / administration & dosage. Testicular Neoplasms / therapy
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Disease-Free Survival. Humans. Male. Middle Aged. Prognosis. Survival Rate. Time Factors. Transplantation, Autologous. Treatment Outcome

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  • [CommentIn] J Clin Oncol. 2003 Nov 15;21(22):4073-4 [14568986.001]
  • (PMID = 14568987.001).
  • [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] Clinical Trial; Clinical Trial, Phase I; Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial
  • [Publication-country] United States
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide; ICE protocol 1
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30. Calaminus G, Bamberg M, Harms D, Jürgens H, Kortmann RD, Sörensen N, Wiestler OD, Göbel U: AFP/beta-HCG secreting CNS germ cell tumors: long-term outcome with respect to initial symptoms and primary tumor resection. Results of the cooperative trial MAKEI 89. Neuropediatrics; 2005 Apr;36(2):71-7
Hazardous Substances Data Bank. LINDANE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] AFP/beta-HCG secreting CNS germ cell tumors: long-term outcome with respect to initial symptoms and primary tumor resection. Results of the cooperative trial MAKEI 89.
  • PURPOSE: The aim of the present study was to evaluate survival and factors influencing long-term outcome of patients with AFP/beta-HCG secreting (non-seminomatous) central nervous system germ cell tumors (secCNSGCT), who were prospectively collected in the cooperative MAKEI (German: maligne Keimzelltumoren) 89 protocol.
  • The protocol recommended, after a clinically or histologically proven diagnosis and cisplatin-based chemotherapy, a resection of residual tumor and craniospinal irradiation (30 Gy) with a tumor boost (20 Gy).
  • CNS dissemination at diagnosis can also be considered as a negative risk factor as 3 of 5 patients with primary dissemination died of the disease.
  • CONCLUSION: Cisplatin-based three agent chemotherapy followed by resection of the residual tumor and craniospinal irradiation (CSI) with tumor boost is a successful and well-tolerated treatment for secCNSGCTs.
  • [MeSH-major] Central Nervous System Neoplasms / mortality. Central Nervous System Neoplasms / surgery. Evaluation Studies as Topic. Germinoma / mortality. Germinoma / surgery
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols. Biomarkers, Tumor. Child. Child, Preschool. Cisplatin / therapeutic use. Cognition / physiology. Combined Modality Therapy / methods. Cranial Irradiation. Female. Humans. Lindane / metabolism. Longitudinal Studies. Male. Prognosis. Prospective Studies. Retrospective Studies. Survival Rate. Time. Time Factors. Treatment Outcome. alpha-Fetoproteins / secretion

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  • (PMID = 15822019.001).
  • [ISSN] 0174-304X
  • [Journal-full-title] Neuropediatrics
  • [ISO-abbreviation] Neuropediatrics
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Biomarkers, Tumor; 0 / alpha-Fetoproteins; 319-85-7 / beta-hexachlorocyclohexane; 59NEE7PCAB / Lindane; Q20Q21Q62J / Cisplatin
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31. Borg M: Germ cell tumours of the central nervous system in children-controversies in radiotherapy. Med Pediatr Oncol; 2003 Jun;40(6):367-74

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Germ cell tumours of the central nervous system in children-controversies in radiotherapy.
  • BACKGROUND: Primary germ cell tumours (GCT) of the central nervous system (CNS) are rare tumours of children and adults.
  • This article reviews the current controversies in the radiotherapeutic management of primary GCT of the CNS.
  • PROCEDURE: A computerised literature search was performed using the Medline database from 1975 to 2000, this being limited to publications written in the English language on CNS GCT in children up to the age of 16 years.
  • RESULTS: Issues in radiation therapy currently undergoing review include the role of cranio-spinal irradiation (CSI), radiation therapy field sizes, the radiation therapy dose, the extent of surgery in combination with radiotherapy, and the role and timing of chemotherapy in combination with radiotherapy.
  • CONCLUSIONS: The excellent outcome in children with pure germinoma of the CNS and the long-term morbidity associated with standard therapy justifies attempts to limit both the total radiation dose and field sizes, with or without the addition of chemotherapy.
  • The poorer outcome associated with non-germinoma GCT justifies a more aggressive approach in children, combining chemotherapy, surgery and virgule, or radiation therapy, based on known prognostic factors.
  • [MeSH-major] Central Nervous System Neoplasms / radiotherapy. Germinoma / radiotherapy
  • [MeSH-minor] Adolescent. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Dose Fractionation. Humans. Infant. Infant, Newborn. Morbidity. Prognosis. Radiation Injuries. Radiotherapy / adverse effects. Radiotherapy / methods

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  • [Copyright] Copyright 2003 Wiley-Liss, Inc.
  • (PMID = 12692804.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 69
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32. Hasegawa T, Kondziolka D, Hadjipanayis CG, Flickinger JC, Lunsford LD: Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases. Pediatr Neurosurg; 2003 Jun;38(6):329-33
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  • [Title] Stereotactic radiosurgery for CNS nongerminomatous germ cell tumors. Report of four cases.
  • All underwent radiosurgery in conjunction with surgical resection, fractionated radiotherapy or chemotherapy.
  • Radiosurgery was performed with mean maximum and marginal doses of 28 and 14 Gy, respectively.
  • [MeSH-major] Brain / surgery. Germinoma / surgery. Pinealoma / surgery. Radiosurgery / instrumentation

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  • [Copyright] Copyright 2003 S. Karger AG, Basel
  • (PMID = 12759512.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Switzerland
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33. Kochi M, Ushio Y: [Chemo-radiotherapy for malignant brain tumors]. Gan To Kagaku Ryoho; 2002 May;29(5):669-76
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  • I) Malignant gliomas: Randomized clinical trials conducted in the USA showed that radiotherapy plus chemotherapy with nitrosoureas offered a long-term survival advantage to patients younger than 60 years old with malignant gliomas.
  • Combination chemotherapy, such as procarbazine/CCNU/vincristine (PCV) must be tested further, and intra-arterial chemotherapy with nitrosoureas offered no survival advantage.
  • Combination chemotherapy with PCV showed efficacy for patients with anaplastic oligodendroglioma and anaplastic oligoastrocytoma.
  • II) Medulloblastoma: The addition of chemotherapy to radiotherapy improved the survival of patients with poor risk medulloblastoma, and may reduce the required craniospinal radiation dose in patients with good risk medulloblastoma.
  • III) Primary CNS lymphoma (PCNSL): Combination of chemotherapy with high-dose MTX and radiotherapy improved survival of patients with PCNSL; however, the neurotoxicity produced by this treatment modality is a serious problem in older patients.
  • IV) Intracranial germ cell tumors: The addition of chemotherapy to radiotherapy may produce long term survival with good quality of life in patients with germinoma.
  • Neoadjuvant therapy consisting of chemotherapy and radiotherapy followed by complete surgical excision improved survival of patients with intracranial nongerminomatous germ cell tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Glioma / drug therapy. Glioma / radiotherapy
  • [MeSH-minor] Astrocytoma / drug therapy. Astrocytoma / radiotherapy. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / radiotherapy. Cerebellar Neoplasms / drug therapy. Cerebellar Neoplasms / radiotherapy. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Doxorubicin / administration & dosage. Humans. Lomustine / administration & dosage. Lymphoma / drug therapy. Lymphoma / radiotherapy. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy. Oligodendroglioma / drug therapy. Oligodendroglioma / radiotherapy. Prednisone / administration & dosage. Procarbazine / administration & dosage. Survival Rate. Vincristine / administration & dosage

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  • (PMID = 12040669.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 35S93Y190K / Procarbazine; 5J49Q6B70F / Vincristine; 7BRF0Z81KG / Lomustine; 80168379AG / Doxorubicin; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; VB0R961HZT / Prednisone; CHOP protocol; PCV protocol
  • [Number-of-references] 52
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34. Brandes AA, Pasetto LM, Monfardini S: The treatment of cranial germ cell tumours. Cancer Treat Rev; 2000 Aug;26(4):233-42
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  • [Title] The treatment of cranial germ cell tumours.
  • Germ cell tumours of the central nervous system (CNS) include many subtypes whose response to treatment varies, even though the symptoms and radiological appearances are similar.
  • Patients with choriocarcinoma, embryonal carcinoma, or yolk sac tumour have the lowest survival rates; patients with germinoma or mature teratoma have longer survival rates.
  • Beside the delayed injury induced by radiotherapy, the late injury induced by chemotherapy is becoming increasingly evident.
  • Cisplatin is considered an indispensable drug, but it may cause renal damage, ototoxicity, peripheral neuropathy and sterility, while etoposide is associated with an excess frequency of second neoplasms.
  • Taking into account all of the published literature, the following therapeutic options are suggested: in pure germinoma tumours (GT) radiotherapy alone will usually ensure adequate control of the disease, and the long-term sequelae may be limited by reducing the dose delivered, as was proposed for germ cell testicular tumours, to 30 Gy to limited fields plus 25-30 Gy to the spinal axis if there is disseminated disease.
  • In cases of recurrence, which should be uncommon, patients may be rescued with both radiotherapy and chemotherapy.
  • In NGGC tumours, the prognosis is more unfavourable and there is often dissemination to the spine at diagnosis; however, the tumour's high chemosensitivity suggests neoadjuvant treatment chemotherapy with cisplatin and etoposide for three cycles followed by consolidation radiotherapy with 40 Gy to the limited fields plus 30 Gy to the spinal axis if disseminated.
  • In our opinion, a higher dose of radiotherapy in cases in which chemotherapy does not achieve a radiological complete remission is not advisable, because very often the residual radiological abnormality does not represent biologically active tumour but differentiated forms such as mature teratoma.
  • The challenge for 2000 is to both cure these patients, and avoid the late and permanent sequelae of radiation and/or chemotherapy that may subsequently impair quality of life.
  • [MeSH-major] Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Combined Modality Therapy. Cranial Irradiation. Drug Therapy. Humans. Neurosurgical Procedures. Prognosis. Radiotherapy Dosage. Survival Rate

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  • [Copyright] Copyright 2000 Harcourt Publishers Ltd.
  • (PMID = 10913379.001).
  • [ISSN] 0305-7372
  • [Journal-full-title] Cancer treatment reviews
  • [ISO-abbreviation] Cancer Treat. Rev.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] ENGLAND
  • [Number-of-references] 59
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35. 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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  • 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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36. Yang QY, Sun XF, Huang HQ, Zhen ZJ, Xia Y, Cai QQ, Ling JY: [Treatment outcome of primary central nervous system germ cell tumors after combined therapy: a report of 23 cases]. Ai Zheng; 2008 Apr;27(4):438-41
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  • [Title] [Treatment outcome of primary central nervous system germ cell tumors after combined therapy: a report of 23 cases].
  • BACKGROUND & OBJECTIVE: Primary central nervous system (CNS) germ cell tumors (GCTs) are rare malignant neoplasms with various histological types.
  • Excluding pure germinoma and mature teratoma, other types carry a poor prognosis.
  • Previous investigations focused on combined modality treatment including chemotherapy to improve survival.
  • This study was to analyze the efficacy and toxicity of chemotherapy combined with surgery and/or radiotherapy on CNS GCTs.
  • METHODS: A total of 23 patients with CNS GCTs were treated in Cancer Center of Sun Yat-sen University from May 2002 to Jun. 2006.
  • All patients were treated with chemotherapy of PEB regimen combined with surgery and/or radiotherapy.
  • RESULTS: Of the 23 patients, 17 newly diagnosed patients received induction chemotherapy followed by radiotherapy or surgery/radiotherapy followed by adjuvant chemotherapy; 6 recurrent patients received salvage chemotherapy, of which 3 patients with disseminated tumor received salvage chemotherapy followed by craniospinal irradiation.
  • Chemotherapy alone gained a response rate of 87.0% and a complete remission rate of 30.4%.
  • Fourteen patients (60.9%) were alive without evidence of diseases after combined modality treatment.
  • CONCLUSIONS: The combined modality treatment including PEB regimen is highly effective in treating CNS GCTs patients, especially in the patients with elevated tumor markers.
  • [MeSH-major] Central Nervous System Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bleomycin / therapeutic use. Cisplatin / therapeutic use. Combined Modality Therapy. Etoposide / therapeutic use. Female. Humans. Male. Survival Rate

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  • (PMID = 18423134.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 11056-06-7 / Bleomycin; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; BEP protocol
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37. 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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38. 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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39. 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

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  • [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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  • [Cites] J Neurosurg. 1999 Feb;90(2):258-64 [9950496.001]
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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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40. Kollmannsberger C, Nichols C, Meisner C, Mayer F, Kanz L, Bokemeyer C: Identification of prognostic subgroups among patients with metastatic 'IGCCCG poor-prognosis' germ-cell cancer: an explorative analysis using cart modeling. Ann Oncol; 2000 Sep;11(9):1115-20
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  • All patients had been treated with cisplatin-etoposide-based chemotherapy within controlled clinical trials between 1984 and 1997.
  • RESULTS: gonadal/retroperitoneal (G/R) primary tumor 260 patients (78%), mediastinal primary tumor 72 patients (22%), visceral metastases 205 patients (62%) including 33 patients with CNS metastases, lung metastases 247 patients (74%), abdominal tumor 241 patients (72%), elevated AFP, beta-HCG or LDH levels 235 (71%), 253 (76%) and 275 (83%) of patients, respectively.
  • Identifying subgroups of 'very poor-prognosis' among 'poor-prognosis' patients may allow to test for new treatment strategies in selected subgroups.

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  • (PMID = 11061604.001).
  • [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] Clinical Trial; Journal Article; Randomized Controlled Trial
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin; 0 / alpha-Fetoproteins; EC 1.1.1.27 / L-Lactate Dehydrogenase
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41. Souweidane MM, Krieger MD, Weiner HL, Finlay JL: Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors. J Neurosurg Pediatr; 2010 Aug;6(2):125-30
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  • [Title] Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors.
  • The successful treatment of children with a primary CNS germ cell tumor can be greatly influenced by the neurosurgeon involved in the diagnostic and therapeutic care of these children.
  • Variability in surgical philosophies no doubt exists due to the relatively infrequent incidence of these tumors, a lack of consensus regarding diagnostic and therapeutic approaches, and the advent of recent surgical innovations.
  • Many of these issues were discussed at the Second International Symposium on Central Nervous System Germ Cell Tumors through presented abstracts and invited presentations.
  • [MeSH-minor] Biomarkers, Tumor / cerebrospinal fluid. Biopsy. Brain / pathology. Brain / surgery. Child. Combined Modality Therapy. Diagnostic Imaging. Endoscopy / methods. Female. Germinoma / drug therapy. Germinoma / pathology. Germinoma / radiotherapy. Germinoma / surgery. Humans. Male. Microsurgery. Neoadjuvant Therapy. Neoplasm Recurrence, Local / drug therapy. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / radiotherapy. Neoplasm Recurrence, Local / surgery. Neuronavigation. Reoperation

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  • (PMID = 20672932.001).
  • [ISSN] 1933-0715
  • [Journal-full-title] Journal of neurosurgery. Pediatrics
  • [ISO-abbreviation] J Neurosurg Pediatr
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 45
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42. 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
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  • [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

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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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