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1. Ogawa K, Toita T, Nakamura K, Uno T, Onishi H, Itami J, Shikama N, Saeki N, Yoshii Y, Murayama S: Treatment and prognosis of patients with intracranial nongerminomatous malignant germ cell tumors: a multiinstitutional retrospective analysis of 41 patients. Cancer; 2003 Jul 15;98(2):369-76
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  • [Title] Treatment and prognosis of patients with intracranial nongerminomatous malignant germ cell tumors: a multiinstitutional retrospective analysis of 41 patients.
  • BACKGROUND: The relative roles of surgical resection, radiotherapy, and chemotherapy in the management of patients with intracranial nongerminomatous malignant germ cell tumors have been controversial.
  • The authors retrospectively investigated the results of different treatment regimens in patients with these tumors.
  • Fifteen patients (37%) underwent surgical resection and received radiotherapy, and 26 patients (63%) also received chemotherapy.
  • In the intermediate prognosis group, the 5-year actuarial overall survival rate was 44% for patients who underwent surgical resection and received radiotherapy (n=9) and 84% for patients who also received chemotherapy (n=15; P=0.01).
  • Patients in the poor prognosis group who underwent surgical resection and received radiotherapy (n=3) or who underwent incomplete resection and received both radiotherapy and chemotherapy (n=8) all died of disease, whereas 2 of 3 patients who underwent macroscopic total resection and received both radiotherapy and chemotherapy survived free of disease.
  • CONCLUSIONS: The treatment of patients with intracranial nongerminomatous malignant germ cell tumors should be based on tumor histology.
  • For patients who had a good prognosis (mature teratoma with germinoma), surgical resection and radiotherapy were sufficient; however, for patients in the intermediate prognosis group, multimodal treatment, including surgical resection, radiotherapy, and chemotherapy, was effective.
  • Conversely, for patients in the poor prognosis group, more intensive multimodal treatment, including macroscopic total resection, may improve the survival rate.
  • [MeSH-major] Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Actuarial Analysis. Adolescent. Adult. Child. Child, Preschool. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local. Prognosis. Retrospective Studies. Survival Rate

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 12872359.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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2. Berney DM, Shamash J, Gaffney J, Jordan S, Oliver RT: DNA topoisomerase I and II expression in drug resistant germ cell tumours. Br J Cancer; 2002 Sep 9;87(6):624-9
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  • [Title] DNA topoisomerase I and II expression in drug resistant germ cell tumours.
  • A small number of testicular germ cell tumours are refractory to current chemotherapy regimens.
  • DNA topoisomerase I is the target for several new drugs and a potential candidate treatment for chemorefractory germ cell tumours.
  • DNA topoisomerase II alpha is the target for etoposide, which is currently used regularly in germ cell tumour treatment.
  • The expression of DNA topoisomerase I and II alpha were therefore assessed immunohistochemically in a range of testicular tumours, especially those with persistent malignant elements on retroperitoneal lymph node dissection.
  • Pre-chemotherapy orchidectomy specimens were matched with post-chemotherapy retroperitoneal lymph node dissections to examine changes in expression.
  • There was considerable variation in the expression of topoisomerase I in different tumour types.
  • There was a negative correlation between topoisomerase I and II alpha expression (P=0.004) and downregulation of topoisomerase II alpha after chemotherapy (P=0.02).
  • These results suggest that topoisomerase I inhibitors may be useful in chemorefractory germ cell tumours, especially yolk sac tumours and where there are unresectable residual teratoma, mature deposits.
  • [MeSH-major] Carcinoma, Embryonal / metabolism. DNA Topoisomerases, Type I / metabolism. DNA Topoisomerases, Type II / metabolism. Drug Resistance, Neoplasm. Seminoma / metabolism. Teratoma / metabolism. Testicular Neoplasms / metabolism
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Case-Control Studies. Cisplatin / administration & dosage. Down-Regulation. Etoposide / administration & dosage. Humans. Immunoenzyme Techniques. Ki-67 Antigen / metabolism. Male. Testis / chemistry. Testis / pathology

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  • (PMID = 12237772.001).
  • [ISSN] 0007-0920
  • [Journal-full-title] British journal of cancer
  • [ISO-abbreviation] Br. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Scotland
  • [Chemical-registry-number] 0 / Ki-67 Antigen; 6PLQ3CP4P3 / Etoposide; EC 5.99.1.2 / DNA Topoisomerases, Type I; EC 5.99.1.3 / DNA Topoisomerases, Type II; Q20Q21Q62J / Cisplatin
  • [Other-IDs] NLM/ PMC2364243
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3. Royds JA, Iacopetta B: p53 and disease: when the guardian angel fails. Cell Death Differ; 2006 Jun;13(6):1017-26
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  • The p53 tumor suppressor gene (TP53) is mutated more often in human cancers than any other gene yet reported.
  • In this review, we discuss the significance of p53 mutations in some of the above tumors with a view to outlining how p53 contributes to malignant progression.
  • We also discuss the usefulness of TP53 status as a prognostic marker and its role as a predictor of response to therapy.
  • [MeSH-major] Brain Neoplasms / genetics. Cell Transformation, Neoplastic / genetics. Glioblastoma / genetics. Li-Fraumeni Syndrome / genetics. Tumor Suppressor Protein p53 / genetics
  • [MeSH-minor] Animals. Apoptosis. Breast Neoplasms / genetics. Breast Neoplasms / metabolism. Breast Neoplasms / pathology. Databases, Genetic. Drug Resistance, Neoplasm / genetics. Germ-Line Mutation. Humans. Inflammation / genetics. Inflammation / metabolism. Meta-Analysis as Topic. Neoplasm Invasiveness. Neurodegenerative Diseases / genetics. Neurodegenerative Diseases / metabolism. Telomerase / metabolism. Telomere / metabolism

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  • (PMID = 16557268.001).
  • [ISSN] 1350-9047
  • [Journal-full-title] Cell death and differentiation
  • [ISO-abbreviation] Cell Death Differ.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Tumor Suppressor Protein p53; EC 2.7.7.49 / Telomerase
  • [Number-of-references] 80
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4. Kochi M, Itoyama Y, Shiraishi S, Kitamura I, Marubayashi T, Ushio Y: Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors. J Neurosurg; 2003 Jul;99(1):106-14
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  • [Title] Successful treatment of intracranial nongerminomatous malignant germ cell tumors by administering neoadjuvant chemotherapy and radiotherapy before excision of residual tumors.
  • OBJECT: The goal of this study was to confirm the effectiveness of our novel treatment strategy, neoadjuvant therapy (NAT) consisting of combined chemo- and radiotherapy, which are performed before complete excision of residual tumor in patients with intracranial nongerminomatous malignant germ cell tumors (NGMGCTs).
  • METHODS: The authors treated 11 consecutive patients with NGMGCTs by applying NAT consisting of combined platinum-based chemotherapy and radiotherapy, followed by complete excision of residual tumors.
  • The pretreatment diagnosis, based on tumor markers with or without biopsy, was yolk sac tumor in five patients, embryonal carcinoma in one patient, immature teratoma in one patient, and mixed germ cell tumor containing malignant tumor components in four patients.
  • Of the 11 patients, 10 are currently alive without recurrence of their disease, 30 to 177 months (mean 96 months) after diagnosis.
  • In one patient a leptomeningeal tumor recurred and he died of the disease 21 months after diagnosis.
  • CONCLUSIONS: Neoadjuvant therapy, consisting of combined chemo- and radiotherapy, followed by complete excision of residual tumors is highly effective in patients with intracranial NGMGCTs.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms. Carcinoma. Endodermal Sinus Tumor. Germinoma. Neoadjuvant Therapy / methods. Neoplasms, Germ Cell and Embryonal
  • [MeSH-minor] Adolescent. Adult. Biomarkers, Tumor. Biopsy. Child. Combined Modality Therapy. Disease Progression. Drug Administration Schedule. Female. Humans. Magnetic Resonance Imaging. Male. Neoplasm, Residual / pathology. Neoplasm, Residual / surgery. Postoperative Care. Quality of Life. Treatment Outcome

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  • (PMID = 12854751.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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5. Vervenne WL, Bakker PJ, Stalpers LJ, Bosch DA: [Malignant intracranial germ cell tumor treated with chemotherapy and radiotherapy without histopathological confirmation]. Ned Tijdschr Geneeskd; 2000 Mar 11;144(11):527-31
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  • [Title] [Malignant intracranial germ cell tumor treated with chemotherapy and radiotherapy without histopathological confirmation].
  • [Transliterated title] Maligne intracerebrale kiemceltumor behandeld met chemotherapie en radiotherapie zonder histopathologische diagnose.
  • In two men aged 19 and 24 years, a rare malignant intracranial germ cell tumour was diagnosed in the pineal gland region and in the second patient in a suprasellar position as well.
  • The clinical picture of a young patient with an intracerebral tumour localised in the midline of the brain and increased levels of the tumour markers alpha-foetoprotein and/or human chorion gonadotrophin (beta-HCG) in blood and/or CSF makes any other diagnosis highly unlikely.
  • There is no place for radical surgery in the first-line treatment of malignant intracerebral germ cell tumours because of the sensitivity to radio- and chemotherapy.
  • Also, the sensitivity to chemotherapy makes it possible to reduce radiation volume and dose in an effort to avoid the serious complications of craniospinal irradiation.
  • Both patients responded well to chemotherapy based on cisplatin followed by radiotherapy.
  • [MeSH-major] Biomarkers, Tumor / metabolism. Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adult. Chemotherapy, Adjuvant. Chorionic Gonadotropin, beta Subunit, Human / blood. Chorionic Gonadotropin, beta Subunit, Human / cerebrospinal fluid. Diagnosis, Differential. Humans. Magnetic Resonance Imaging. Male. Radiotherapy, Adjuvant. Tomography, X-Ray Computed. Treatment Outcome. alpha-Fetoproteins / cerebrospinal fluid

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  • (PMID = 10735140.001).
  • [ISSN] 0028-2162
  • [Journal-full-title] Nederlands tijdschrift voor geneeskunde
  • [ISO-abbreviation] Ned Tijdschr Geneeskd
  • [Language] dut
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] NETHERLANDS
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Chorionic Gonadotropin, beta Subunit, Human; 0 / alpha-Fetoproteins
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6. 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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  • [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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7. Kendi TK, Caglar S, Huvaj S, Bademci G, Kendi M, Alparslan S: Suprasellar germ cell tumor with subarachnoid seeding MRI and MR spectroscopy findings. Clin Imaging; 2004 Nov-Dec;28(6):404-7
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  • [Title] Suprasellar germ cell tumor with subarachnoid seeding MRI and MR spectroscopy findings.
  • Patient had a history of depression unresponsive to drug therapy and recently developed diabetes insipidus.
  • MR spectroscopy of the mass showed prominent lipid peak suggesting high malignant potential.
  • [MeSH-major] Brain Neoplasms / diagnosis. Germinoma / diagnosis. Magnetic Resonance Imaging / methods. Neoplasm Invasiveness / pathology. Tomography, Emission-Computed, Single-Photon / methods

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  • (PMID = 15531139.001).
  • [ISSN] 0899-7071
  • [Journal-full-title] Clinical imaging
  • [ISO-abbreviation] Clin Imaging
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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8. Calaminus G, Bamberg M, Jürgens H, Kortmann RD, Sörensen N, Wiestler OD, Göbel U: Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89. Klin Padiatr; 2004 May-Jun;216(3):141-9
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  • [Title] Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89.
  • Malignant non-germinomatous intracranial germ cell tumors (MNGGCTs) are a heterogenous group of neoplastic lesions.
  • Their treatment concept follows a multimodal concept that may include tumor resection for local tumor control, craniospinal irradiation to cover leptomenigeal tumor spread and chemotherapy to eliminate systemic tumor dissemination.
  • A Platinum-based chemotherapy proven to be highly effective in testicular and non-testicular malignant germ cell tumors in adults as well as in children has also been chosen for intracranial sites.
  • While therapeutic concepts have been thoroughly evaluated for children and adolescents with extracranial nongonadal GCTs, no such detailed long term follow-up data are available for intracranial MNGGCTs.
  • This paper reports on the long-term outcome of 41 patients with intracranial malignant non-germinomatous GCTs enrolled into the German prospective protocol MAKEI 89.
  • The analysis focuses on the impact of surgery, radio- and chemotherapy.
  • PATIENTS AND METHODS: Between January 1989 and January 1994, 41 patients with malignant intracranial non-germinomatous GCTs were registered.
  • Patients were compared in respect to protocol (n = 27) and non-protocol treatment (n = 14).
  • Estimated were with chi (2) and Fisher exact test the impact of surgery, chemotherapy and irradiation on outcome.
  • RESULTS: The estimated (Kaplan-Meier) 5-year event free survival (EFS) of patients treated according to protocol recommendations was 0.59 +/- 0.06 (n = 27), compared to an EFS of 0.37 +/- 0.33 for patients with different treatments (n = 14) (p = 0.70, log-rank).
  • The 5-year relapse-free survival rate (RFS) was 0.74 +/- 0.06 in protocol patients and 0.38 +/- 0.33 in non-protocol patients (median observation time of 112 months after diagnosis for surviving patients) (p = 0.14, log-rank).
  • CONCLUSION: Cisplatin chemotherapy and craniospinal irradiation with tumor boost are of significant influence on long term survival in patients with MNGGCTs.
  • The exclusion of major surgery at diagnosis using modern advances in neurosurgery or related tumor resection after neoadjuvant chemotherapy will allow a further reduction of treatment related mortality and long lasting morbidity.
  • The analysis reveals that, given effective treatment, intracranial malignant non-germinomatous GCTs should not longer carry a poor prognosis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / surgery. Cisplatin / administration & dosage. Cranial Irradiation. Neoadjuvant Therapy. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / surgery. Pinealoma / surgery
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Disease-Free Survival. Female. Follow-Up Studies. Germany. Humans. Male. Prognosis. Prospective Studies. Radiotherapy, Adjuvant. Survival Analysis

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  • (PMID = 15175958.001).
  • [ISSN] 0300-8630
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin
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9. Doolittle ND, Miner ME, Hall WA, Siegal T, Jerome E, Osztie E, McAllister LD, Bubalo JS, Kraemer DF, Fortin D, Nixon R, Muldoon LL, Neuwelt EA: Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjunction with osmotic opening of the blood-brain barrier for the treatment of patients with malignant brain tumors. Cancer; 2000 Feb 1;88(3):637-47
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  • [Title] Safety and efficacy of a multicenter study using intraarterial chemotherapy in conjunction with osmotic opening of the blood-brain barrier for the treatment of patients with malignant brain tumors.
  • BACKGROUND: The aim of this study was to determine the safety and efficacy of intraarterial chemotherapy with osmotic opening of the blood-brain barrier (BBB) for the treatment of malignant brain tumors when administered across multiple centers.
  • METHODS: Patients with primary central nervous system lymphoma (PCNSL), primitive neuroectodermal tumor (PNET), germ cell tumor, cancer metastasis to the brain, or low or high grade glioma were eligible.
  • Prior to entry, magnetic resonance imaging or computed tomography brain scan, medical history, neurologic status, and Karnofsky performance status were reviewed at the coordinating center.
  • Between March 1994 and November 1997, 5 universities treated 221 adult patients with intraarterial chemotherapy with or without osmotic opening of the BBB (2464 procedures).
  • All evaluable patients with PNET (n = 17), metastatic disease (n = 12), or germ cell tumor (n = 4) achieved stable disease (SD) or better.
  • One patient with extensive glioma expired within 48 hours after treatment.
  • CONCLUSIONS: Using standard guidelines and protocols, intraarterial chemotherapy with or without osmotic opening of the BBB is feasible across multiple centers with a low incidence of catheter-related complications.
  • In patients with chemotherapy-sensitive tumors, such as PCNSL, PNET, germ cell tumor, and cancer metastasis to the central nervous system, enhanced delivery results in a high degree of tumor response, with an efficacy profile that is reproducible across multiple centers.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Blood-Brain Barrier / drug effects. Brain Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Feasibility Studies. Female. Germinoma / drug therapy. Glioblastoma / drug therapy. Glioma / drug therapy. Humans. Injections, Intra-Arterial / adverse effects. Injections, Intra-Arterial / instrumentation. Karnofsky Performance Status. Lymphoma / drug therapy. Magnetic Resonance Imaging. Male. Middle Aged. Neuroectodermal Tumors / drug therapy. Neurologic Examination. Osmosis. Remission Induction. Reproducibility of Results. Safety. Tomography, X-Ray Computed

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  • [Copyright] Copyright 2000 American Cancer Society.
  • (PMID = 10649259.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / R01 CA 31770; United States / NINDS NIH HHS / NS / R01 NS 33618; United States / NINDS NIH HHS / NS / R01 NS 34608
  • [Publication-type] Clinical Trial; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] UNITED STATES
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10. Geyer JR, Sposto R, Jennings M, Boyett JM, Axtell RA, Breiger D, Broxson E, Donahue B, Finlay JL, Goldwein JW, Heier LA, Johnson D, Mazewski C, Miller DC, Packer R, Puccetti D, Radcliffe J, Tao ML, Shiminski-Maher T, Children's Cancer Group: Multiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the Children's Cancer Group. J Clin Oncol; 2005 Oct 20;23(30):7621-31
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  • [Title] Multiagent chemotherapy and deferred radiotherapy in infants with malignant brain tumors: a report from the Children's Cancer Group.
  • PURPOSE: To evaluate response rate, event-free survival (EFS), and toxicity of two chemotherapeutic regimens for treatment of children younger than 36 months with malignant brain tumors and to estimate control intervals without irradiation in children with no residual tumor after initial surgery and induction chemotherapy and with delayed irradiation in patients with residual tumor or metastatic disease at diagnosis.
  • PATIENTS AND METHODS: Patients were randomly assigned to one of two regimens of induction chemotherapy (vincristine, cisplatin, cyclophosphamide, and etoposide v vincristine, carboplatin, ifosfamide, and etoposide).
  • Maintenance chemotherapy began after induction in children without progressive disease.
  • Children with no residual tumors after induction therapy and no metastatic disease at diagnosis were not to receive radiation therapy unless their tumors progressed.
  • Forty-two percent of patients responded to induction chemotherapy.
  • For medulloblastoma, supratentorial primitive neuroectodermal tumor, ependymoma, and rhabdoid tumors, 5-year EFS rates were 32% +/- 5%, 17% +/- 6%, and 32% +/- 6%, and 14% +/- 7%, respectively.
  • Fifty-eight percent of patients who were alive 5 years after study entry had not received radiation therapy.
  • CONCLUSION: Intensified induction chemotherapy resulted in a high response rate of malignant brain tumors in infants.
  • Survival was comparable to that of previous studies, and most patients who survived did not receive radiation therapy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy
  • [MeSH-minor] Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Cyclophosphamide / administration & dosage. Ependymoma / drug therapy. Ependymoma / radiotherapy. Ependymoma / surgery. Etoposide / administration & dosage. Female. Glioma / drug therapy. Glioma / radiotherapy. Glioma / surgery. Humans. Ifosfamide / administration & dosage. Infant. Infant, Newborn. Male. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy. Medulloblastoma / surgery. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / radiotherapy. Neoplasms, Germ Cell and Embryonal / surgery. Neuroectodermal Tumors, Primitive, Peripheral / drug therapy. Neuroectodermal Tumors, Primitive, Peripheral / radiotherapy. Neuroectodermal Tumors, Primitive, Peripheral / surgery. Survival Rate. Treatment Outcome. Vincristine / administration & dosage

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  • (PMID = 16234523.001).
  • [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
  • [Grant] United States / NCI NIH HHS / CA / CA 10382
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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11. Wong JM, Chi SN, Marcus KJ, Levine BS, Ullrich NJ, MacDonald S, Lechpammer M, Goumnerova LC: Germinoma with malignant transformation to nongerminomatous germ cell tumor. J Neurosurg Pediatr; 2010 Sep;6(3):295-8
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  • [Title] Germinoma with malignant transformation to nongerminomatous germ cell tumor.
  • Six weeks after this diagnosis, just prior to initiation of therapy, serum and CSF marker analysis revealed sudden and marked elevation of alpha-fetoprotein, indicating transformation of her germinoma to a nongerminomatous germ cell tumor.
  • She underwent chemotherapy and radiation therapy per the national treatment approach for the new diagnosis, with subsequent return of her serum and CSF tumor markers to normal levels.
  • To the authors' knowledge, this is the first case in the English-language literature of a nongerminomatous germ cell tumor resulting from conversion of germinoma at the original site of presentation.
  • [MeSH-major] Brain Neoplasms / diagnosis. Germinoma / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis


12. Kunishio K, Okada M, Miyake K, Matsumoto Y, Nagao S, Nishiyama Y, Ohkawa M: [Report of two cases with germinoma treated by individual adjuvant chemotherapy based on the mRNA expression of drug-resistance gene]. No Shinkei Geka; 2004 Jan;32(1):19-26
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  • [Title] [Report of two cases with germinoma treated by individual adjuvant chemotherapy based on the mRNA expression of drug-resistance gene].
  • We reported two cases with germ cell tumor in which new preliminary treatment trials were performed by chemotherapy using anti-cancer drug selected on the basis of multidrug resistance gene mRNA expression, such as MDR1, MRP1, MRP2, MXR1, MGMT, GST pi and TopoII alpha, from RT-PCR assay.
  • A 28-year-old male had gradually developed DI.
  • Biopsy of tumor in the medulla oblongata demonstrated germinoma histologically.
  • RT-PCR assay of this tissue revealed overexpression of MRP1, MGMT and GST pi mRNA, but neither MDR1, MRP2 nor MXR1 was observed.
  • MR imaging revealed enhanced tumor in the pineal region.
  • The tumor was diagnosed as a malignant germ cell tumor, histopathologically.
  • RT-PCR assay of this tissue revealed overexpression of MRP1, MRP2, MXR1, MGMT and GST pi mRNA.
  • The patient was treated by irradiation including radiosurgery combined with chemotherapy, given cisplatin, etoposide and ifosphamide (ICE regimen), but he died because of progressive disease such as CSF dissemination.
  • It seems that preliminary individual adjuvant chemotherapy based on mRNA expression of drug-resistance gene is available for the treatment of germ cell tumors.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / genetics. Brain Neoplasms / therapy. Drug Resistance, Neoplasm / genetics. Gene Expression. Genes, MDR / genetics. Germinoma / genetics. Germinoma / therapy. RNA, Messenger
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Cisplatin / administration & dosage. Etoposide / administration & dosage. Fatal Outcome. Humans. Ifosfamide / administration & dosage. Male. Pharmacogenetics. Treatment Outcome

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  • (PMID = 14978920.001).
  • [ISSN] 0301-2603
  • [Journal-full-title] No shinkei geka. Neurological surgery
  • [ISO-abbreviation] No Shinkei Geka
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / RNA, Messenger; 6PLQ3CP4P3 / Etoposide; Q20Q21Q62J / Cisplatin; UM20QQM95Y / Ifosfamide
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13. Friedman JA, Lynch JJ, Buckner JC, Scheithauer BW, Raffel C: Management of malignant pineal germ cell tumors with residual mature teratoma. Neurosurgery; 2001 Mar;48(3):518-22; discussion 522-3
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  • [Title] Management of malignant pineal germ cell tumors with residual mature teratoma.
  • OBJECTIVE: The treatment of intracranial mixed germ cell tumors presents a unique challenge, since eradication of malignant tumor by radiation and/or chemotherapy may spare the benign tumor component.
  • We reviewed our surgical experience with residual malignant pineal germ cell tumors after neoadjuvant therapy.
  • METHODS: Between 1987 and 1997, 16 patients with malignant intracranial germ cell tumors were treated at the Mayo Clinic with a protocol of neoadjuvant chemotherapy and radiation therapy.
  • After the diagnosis was confirmed by histopathological examination, all patients were treated with four cycles of etoposide and cisplatin as well as external beam radiation therapy (range, 3030-5940 cGy).
  • Six patients had an incomplete response to therapy, as demonstrated by observation of residual tumor on magnetic resonance imaging scans.
  • Initial pathology in these six patients was germinoma in four and combinations of yolk sac tumor, embryonal carcinoma, malignant teratoma, and germinoma in two.
  • Tumor markers were elevated in four of the six patients at presentation.
  • CONCLUSION: Residual pineal tumor occurring after treatment of malignant intracranial germ cell tumor with neoadjuvant therapy is likely to be mature teratoma.
  • [MeSH-major] Brain Neoplasms / surgery. Germinoma / surgery. Neoplasms, Multiple Primary / surgery. Pineal Gland. Teratoma / surgery
  • [MeSH-minor] Adolescent. Adult. Algorithms. Child. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Male. Neoplasm, Residual


14. Nomura K: Epidemiology of germ cell tumors in Asia of pineal region tumor. J Neurooncol; 2001 Sep;54(3):211-7
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  • [Title] Epidemiology of germ cell tumors in Asia of pineal region tumor.
  • In the Brain Tumor Registry of Japan (BTRJ), there were 38,273 primary brain tumors except those of unknown histology (1123 cases) registered in the period between 1984 and 1993, in which 807 pineal region tumors with 104 unknown histology were registered in BTRJ.
  • Of these pineal region tumors, germ cell tumors had the highest frequency, 70.3%, followed by pineal parenchymal tumors, 12.0%; pineocytoma in 7.8% and pineoblastoma in 4.2%.
  • Limited to germ cell tumors, germinoma was 68.0%, then teratoma including malignant teratoma, had the second high frequency, 14.7% in pineal region.
  • While data reported by Allaire et al. and Edwards et al. revealed that the incidence of germinoma was 88.6%, 52.4% of germ cell tumors in pineal region in France and in USA, respectively.
  • Although number of cases is very small, it is suggested that the percentage of germinoma in germ cell tumors in the pineal region might be almost the same in Western countries as in Asian countries, and the occurrence of germ cell tumors in the pineal region was much higher than those in Asia.
  • Age and gender distribution of pineal region tumors indicated that germ cell tumors and pineocytoma showed a high incidence in males and in children.
  • Most of malignant pineal region tumors other than germinomas showed poor prognosis, but recent progress in surgical techniques and effective chemotherapy will improve the prognosis.
  • [MeSH-major] Brain Neoplasms / epidemiology. Germinoma / epidemiology. Pineal Gland

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  • (PMID = 11767288.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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15. 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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  • [Title] Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation.
  • 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.
  • Initial tumor markers for beta-human chorionic gonadotrophin (HCGbeta) and alpha-fetoprotein (AFP) were evaluated in serum and lumbar cerebrospinal fluid (CSF).
  • Endoscopic biopsies were performed in 12 patients and partial resections in the remaining 8 patients at diagnosis.
  • Neurocognitive function was evaluated periodically following treatment.
  • RESULTS: Eighteen of 20 patients are without evidence of residual or recurrent tumor.
  • Both relapsing patients were subsequently determined to harbor malignant non-germinomatous germ cell tumor (NGGCT).
  • 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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16. Osada T, Fujimaki T, Takamizawa M, Tsuno NH, Kirino T, Shibata Y: Dendritic cells activate antitumor immunity for malignant intracranial germ cell tumor: a case report. Jpn J Clin Oncol; 2001 Aug;31(8):403-6
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  • [Title] Dendritic cells activate antitumor immunity for malignant intracranial germ cell tumor: a case report.
  • We report a 22-year-old male patient with a history of intracranial malignant germ cell tumor (GCT) who had undergone tumor resection twice, followed by radiation and chemotherapy.
  • The tumor had rapidly recurred along the entire ventricular wall with extensive invasion into the brain parenchyma.
  • Although tissue samples of the recurrent tumor could not be obtained, the previous histological diagnosis of germinoma and elevated serum beta-hCG levels suggested recurrence of malignant GCT.
  • The patient declined chemotherapy but accepted dendritic cell (DC)-based immunotherapy.
  • DC inoculation five times resulted in rapid tumor shrinkage and a significant decrease in the serum level of beta-hCG.
  • Here we discuss the effectiveness of immunotherapy using DCs for recurrent intracranial malignant GCTs.
  • [MeSH-major] Brain Neoplasms / therapy. Dendritic Cells / immunology. Germinoma / therapy. Immunotherapy. Neoplasm Recurrence, Local / therapy

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  • (PMID = 11574635.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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17. Hale GA, Greenwood MF, Geil JD, Moscow JA: Langerhans cell histiocytosis after therapy for a malignant germ cell tumor of the central nervous system. J Pediatr Hematol Oncol; 2000 Jul-Aug;22(4):355-7
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  • [Title] Langerhans cell histiocytosis after therapy for a malignant germ cell tumor of the central nervous system.
  • Langerhans cell histiocytosis (LCH) is a clonal neoplastic disorder that results in a spectrum of clinical manifestations.
  • Known to be associated with a variety of malignant diseases, LCH may precede, coincide with, or develop after the diagnosis of cancer.
  • A child with a malignant germ cell tumor of the brain who subsequently experienced LCH is reported.
  • The 8-year-old boy was treated for an immature teratoma of the posterior fossa with gross total resection and craniospinal irradiation preceding bleomycin, etoposide, and vinblastine chemotherapy for four cycles.
  • Seven months after completion of therapy, he experienced multifocal bone disease with LCH.
  • [MeSH-major] Bone Neoplasms / etiology. Brain Neoplasms / pathology. Histiocytosis, Langerhans-Cell / etiology. Neoplasms, Second Primary / etiology. Teratoma / pathology


18. Göbel U, Schneider DT, Teske C, Schönberger S, Calaminus G: Brain metastases in children and adolescents with extracranial germ cell tumor - data of the MAHO/MAKEI-registry. Klin Padiatr; 2010 May;222(3):140-4
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  • [Title] Brain metastases in children and adolescents with extracranial germ cell tumor - data of the MAHO/MAKEI-registry.
  • BACKGROUND: We analyzed 15 children and adolescents with extracranial germ cell tumor (GCT) and brain metastases reported to the MAHO/MAKEI registry.
  • All patients with advanced malignant GCTs received cisplatin-based chemotherapy (overall survival: 0.81+/-0.04 (734/823).
  • RESULTS: 15 patients with brain metastases were reported; in 6 of them at diagnosis and 9 respectively during follow-up (6 weeks-28 months after end of therapy, mean=10 months).
  • In all patients with secondary brain metastases the previously normalised tumor markers AFP and/ or HCG increased again prior to the onset of neurological symptoms.
  • Only 1 of the patients with primary brain metastases survived, whereas 4 of 9 with secondary metastases are in remission after additional treatment.
  • Development of neurological symptoms at initial diagnosis or during follow-up should lead to rapid clinical re-evaluation including CNS imaging and assessment of tumor markers.
  • Treatment of brain metastases includes intensified chemotherapy and surgical resection, irradiation has to be considered in special clinical situations.
  • [MeSH-major] Brain Neoplasms / secondary. Neoplasms, Germ Cell and Embryonal / secondary. Registries
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biomarkers, Tumor / blood. Child. Child, Preschool. Cisplatin / administration & dosage. Combined Modality Therapy. Cranial Irradiation. Craniotomy. Female. Humans. Infant. Male. Prospective Studies. Risk Factors. Survival Rate

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  • (PMID = 20514616.001).
  • [ISSN] 1439-3824
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; Q20Q21Q62J / Cisplatin
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19. Lutterbach J, Spetzger U, Bartelt S, Pagenstecher A: Malignant germ cell tumors metastatic to the brain: a model for a curable neoplasm? The Freiburg experience and a review of the literature. J Neurooncol; 2002 Jun;58(2):147-56
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  • [Title] Malignant germ cell tumors metastatic to the brain: a model for a curable neoplasm? The Freiburg experience and a review of the literature.
  • The aim of this study on malignant germ cell tumors metastasizing to the brain is (a) to report our institutional experience, (b) to present three patients surviving for more than seven years, and (c) to review the literature with regard to long-term survival.
  • From 1985 to 2000, 916 consecutive patients were treated with whole brain radiation therapy for brain metastases at our hospital.
  • Eleven patients had cerebral lesions from histologically proven malignant germ cell tumors.
  • Brain metastases were diagnosed at presentation (n = 2), following complete remission (n = 3), or along with extracerebral tumor progression (n = 6).
  • Seven patients had a single brain metastasis.
  • Eight patients reached the planned total dose of 50 Gy.
  • Eight patients had chemotherapy.
  • The long-term survivors all had an isolated cerebral relapse after complete remission, presented with a single brain metastasis, and were treated with resection and whole brain radiation therapy to a total dose of 50 Gy.
  • The first patient died from a late relapse 89 months after the diagnosis of brain metastasis, the second patient is well and alive at 95 months.
  • He is alive at 194 months, the longest survival for brain metastases from malignant germ cell tumors ever reported.
  • Altogether, our study demonstrates that advanced extracerebral disease at initial diagnosis and isolated cerebral relapse after complete remission do not preclude long-term survival.
  • Resection and whole brain radiation therapy might result in durable cerebral control with minimal morbidity.
  • [MeSH-major] Brain Neoplasms / secondary. Germinoma / secondary. Testicular Neoplasms / pathology
  • [MeSH-minor] Adolescent. Adult. Combined Modality Therapy. Humans. Male. Middle Aged. Survival Analysis

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  • (PMID = 12164687.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 37
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20. Calaminus G, Göbel U, Schrum J, Wittkugel O, Westphal M, Timmermann B: Proton beam therapy for loco-regional control of a recurrent mixed malignant germ cell tumor of the skull in a 22-month-old girl. Klin Padiatr; 2010 May;222(3):175-9
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  • [Title] Proton beam therapy for loco-regional control of a recurrent mixed malignant germ cell tumor of the skull in a 22-month-old girl.
  • BACKGROUND: Germ cell tumors (GCT) situated in the head and neck region are very rare and occur predominantely in newborns or young infants.
  • Recurrent CTs are often resectable only by mutilating surgery and the need for alternative treatment strategies is obvious.
  • In this situation radiation therapy is the most important treatment option for loco-regional tumor control, but bear in this area the risk of possible impairment of brain function and face deformation as long term effects.
  • CASE REPORT: In a girl with a connatal expansive growing teratoma of the skull the tumor recurred in spite of repeated surgery as mixed malignant GCT at the age of 15 months.
  • Tumor control could not be achieved with chemotherapy and additional surgery seemed not promising.
  • Therefore high dose proton beam therapy (PT) (54 Gy) has been administered to the child at the age of 22 months and led to local tumor control with only mild side effects.
  • CONCLUSION: PT treatment may be an option for specific clinical conditions in germ cell tumors where local tumor control cannot be achieved by chemotherapy and/or surgery and long lasting side effects of conventional radiotherapy due to tumor localization and age have to be considered.
  • However, PT should be implemented in treatment protocols for specific situations to guarantee supervised application, central documentation and follow-up.
  • [MeSH-major] Neoplasm Recurrence, Local / radiotherapy. Orbital Neoplasms / congenital. Orbital Neoplasms / radiotherapy. Protons / therapeutic use. Radiotherapy Planning, Computer-Assisted. Skull Base Neoplasms / congenital. Skull Base Neoplasms / radiotherapy. Teratoma / congenital. Teratoma / radiotherapy

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  • (PMID = 20514623.001).
  • [ISSN] 1439-3824
  • [Journal-full-title] Klinische Pädiatrie
  • [ISO-abbreviation] Klin Padiatr
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Protons
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21. Rejlekova K, Mego M, Rajec J, Sycova-Mila Z, Obertova J, Mardiak J: A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour. Bratisl Lek Listy; 2009;110(5):296-7
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  • [Title] A rare case of malignant extragonadal germ cell tumor in the pineal region with an aggressive behaviour.
  • Though germ cell cancer is rare, it is the most common cancer in males between 20 and 40 years.
  • The primary site for the development of germ cell tumor is testes, but it can be seen in extragonadal locations as well.
  • Herein, we present a rare case of a 19-year-old patient with non/seminomatous extragonadal germ cell tumor in the pineal region with an aggressive behaviour, refractory to the combined therapy (surgery, radio- and chemotherapy).
  • We suggest that early diagnosis and aggressive multimodal approaches along with surgery, radiotherapy and chemotherapy is necessary to improve the outcome of these patients (Ref. 5).
  • [MeSH-major] Brain Neoplasms. Neoplasms, Germ Cell and Embryonal. Pineal Gland

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  • (PMID = 19507665.001).
  • [ISSN] 0006-9248
  • [Journal-full-title] Bratislavské lekárske listy
  • [ISO-abbreviation] Bratisl Lek Listy
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Slovakia
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22. Isaacs H Jr: Perinatal (fetal and neonatal) germ cell tumors. J Pediatr Surg; 2004 Jul;39(7):1003-13
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  • [Title] Perinatal (fetal and neonatal) germ cell tumors.
  • BACKGROUND/PURPOSE: Germ cell tumors are relatively common in the fetus and neonate and are the leading neoplasms in some perinatal reviews.
  • The purpose of this study is to focus on the fetus and neonate in an attempt to determine the various ways germ cell tumors differ clinically and morphologically from those occurring in the older child and adult and to show that certain types of tumors have a better prognosis than others.
  • METHODS: The author conducted a retrospective review of perinatal teratomas and other germ cell tumors reported in the literature and of patients treated and followed up at Children's Hospital San Diego and Children's Hospital Los Angeles.
  • The incidence of teratoma with yolk sac tumor either at presentation or at recurrence was 5.8%, and the survival rate was 39%.
  • Sacrococcygeal teratomas had the highest incidence of yolk sac tumor at 10%.
  • Recurrent disease in the form of either teratoma or yolk sac tumor developed in 5% of patients.
  • CONCLUSIONS: Some germ cell tumors of the fetus and neonate have a better prognosis than others.
  • Neonates with gastric teratomas have the best survival rates, and those with intracranial germ cell tumors the worst.
  • Fetuses with teratomas detected antenatally have 3 times the mortality rate compared with postnatally diagnosed neonates.
  • Surgical resection alone may be adequate therapy for teratomas with nonmetastatic, microscopic foci of yolk sac tumor.
  • In the nonteratoma group, patients with pure yolk sac tumor and gonadoblastoma have a much better outcome than those with choriocarcinoma, which has a very low survival of rate of 12%.
  • Currently, the use of platinum-based combination chemotherapy has significantly improved the survival rate of infants with advanced malignant germ cell tumor disease.
  • [MeSH-major] Abnormalities, Multiple / epidemiology. Fetal Diseases / classification. Fetal Diseases / epidemiology. Head and Neck Neoplasms / epidemiology. Neoplasms, Germ Cell and Embryonal / classification. Neoplasms, Germ Cell and Embryonal / epidemiology
  • [MeSH-minor] Brain Neoplasms / epidemiology. Comorbidity. Digestive System Neoplasms / epidemiology. Endodermal Sinus Tumor / epidemiology. Female. Humans. Infant. Infant, Newborn. Los Angeles / epidemiology. Male. Neoplasm Recurrence, Local / epidemiology. Retrospective Studies. Sacrococcygeal Region. Spinal Neoplasms / epidemiology. Survival Rate. Teratoma / epidemiology. Ultrasonography, Prenatal

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  • (PMID = 15213888.001).
  • [ISSN] 1531-5037
  • [Journal-full-title] Journal of pediatric surgery
  • [ISO-abbreviation] J. Pediatr. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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23. Huang X, Zhang R, Zhou LF: [Grading system for diagnosis and treatment of intracranial nongerminomatous malignant germ cell tumors]. Zhonghua Yi Xue Za Zhi; 2009 Sep 8;89(33):2333-6
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  • [Title] [Grading system for diagnosis and treatment of intracranial nongerminomatous malignant germ cell tumors].
  • OBJECTIVE: To discuss the clinical feature, treatment and prognosis of intracranial nongerminomatous malignant germ cell tumors (NGMGCT).
  • METHODS: The records of 39 patients receiving treatment at our hospital between 1995 and 2007 were reviewed retrospectively.
  • According to the classification of Matsutani, they were grouped into intermediate prognosis and poor prognosis groups based on tumor histology.
  • Clinical manifestations, diagnosis, treatment and outcome were analyzed in each group.
  • RESULTS: In these 39 cases, there were 15 mix germ cell tumors, 15 immature teratomas, 7 embryonal carcinomas and 2 yolk sac tumors.
  • The tumor was totally removed in 29 cases, sub-totally in 5 and partially in 3.
  • Surgery remains the first choice for NGMGCT since treatment should be based on tumor histology.
  • For patients in the intermediate prognosis group, a combined regimen of surgical resection, radiotherapy, chemotherapy and gamma knife surgery is mostly effective.
  • [MeSH-major] Brain Neoplasms / classification. Neoplasms, Germ Cell and Embryonal / classification
  • [MeSH-minor] Adolescent. Adult. Chemotherapy, Adjuvant. Child. Child, Preschool. Female. Humans. Male. Prognosis. Radiotherapy, Adjuvant. Retrospective Studies. Treatment Outcome. Young Adult

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  • (PMID = 20095355.001).
  • [ISSN] 0376-2491
  • [Journal-full-title] Zhonghua yi xue za zhi
  • [ISO-abbreviation] Zhonghua Yi Xue Za Zhi
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
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24. Fujimaki T, Mishima K, Asai A, Tabuchi K, Kobayashi M, Suzuki I, Kirino T: Levels of beta-human chorionic gonadotropin in cerebrospinal fluid of patients with malignant germ cell tumor can be used to detect early recurrence and monitor the response to treatment. Jpn J Clin Oncol; 2000 Jul;30(7):291-4
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  • [Title] Levels of beta-human chorionic gonadotropin in cerebrospinal fluid of patients with malignant germ cell tumor can be used to detect early recurrence and monitor the response to treatment.
  • BACKGROUND: Tumor marker-producing germ cell tumors of the central nervous system are malignant and require radiation and/or chemotherapy.
  • Although serum beta-human chorionic gonadotropin (hCG) has been used to monitor the course of treatment, the levels of beta-hCG in the cerebrospinal fluid (CSF) have not been measured routinely in the clinic.
  • To determine whether they can be used to evaluate parameters of tumor status, such as progression or response to therapy, levels of beta-hCG in the serum and CSF of patients with germ cell tumors were studied.
  • METHODS: Fifty-four paired samples of CSF and serum were taken from seven patients with germ cell tumor and their beta-hCG levels were measured.
  • Beta-hCG was negative in both serum and CSF in 11 instances and the levels in the other 43 paired samples were analyzed for any correlation or relationship to therapy.
  • In all the paired samples except for one time point, the level in CSF was higher than that in serum.
  • Among cases of recurrent malignant germ cell tumor, there were nine instances of recurrence or progression despite therapy.
  • CONCLUSION: It seems likely that the level of beta-hCG in CSF is a good marker for monitoring tumor recurrence or evaluation of treatment results.
  • [MeSH-major] Brain Neoplasms / diagnosis. Cerebrospinal Fluid / chemistry. Chorionic Gonadotropin, beta Subunit, Human / analysis. Germinoma / diagnosis

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  • (PMID = 11007160.001).
  • [ISSN] 0368-2811
  • [Journal-full-title] Japanese journal of clinical oncology
  • [ISO-abbreviation] Jpn. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] JAPAN
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin, beta Subunit, Human
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25. Göbel U, Schneider DT, Calaminus G, Haas RJ, Schmidt P, Harms D: Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups. Ann Oncol; 2000 Mar;11(3):263-71

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Germ-cell tumors in childhood and adolescence. GPOH MAKEI and the MAHO study groups.
  • In mature and immature teratoma the treatment is surgical.
  • In case of a microscopically complete tumor resection there is no role for adjuvant chemo- or radiotherapy irrespective of the histological grade of immaturity.
  • Malignant germ-cell tumors (GCT) account for 2.9% of all malignant tumors of children younger than 15 years of age.
  • More than half of the tumors occur at extragonadal sites such as the ovaries (26%), the coccygeal region (24%), the testes (18%) and the brain (18%) represent then primary sites.
  • In patients with extensive tumor growth, metastatic disease or secreting intracranial tumors a delayed tumor resection after preoperative chemotherapy is preferable.
  • In these patients malignant non-seminomatous GCT may be diagnosed clinically due to the increased serum or cerebrospinal fluid levels of the tumor markers AFP and/or beta-HCG.
  • Current risk adapted treatment protocols containing cisplatinum allow long-term remissions in about 80% including patients with bulky or metastatic tumors.
  • In the cisplatinum era the prognostic factors like histology, primary site of the tumor and initial tumor stage have partly lost their former impressive significance in infants and children.
  • On the other hand the completeness of the primary tumor resection according to oncological standards has been established as the most powerful prognostic parameter superior to tumor marker levels or primary site of the tumor.

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  • (PMID = 10811491.001).
  • [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; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Biomarkers; 0 / Biomarkers, Tumor
  • [Number-of-references] 44
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26. Sawamura Y: Strategy of combined treatment of germ cell tumors. Prog Neurol Surg; 2009;23:86-95
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  • [Title] Strategy of combined treatment of germ cell tumors.
  • The histopathological entity 'germ cell tumor' (GCT) encompasses a number of histological subtypes.
  • Germinoma and mature teratoma are curable and classified into the good prognostic group, whereas embryonal carcinoma, yolk sac tumor, and other highly malignant neoplasms leave patients with a dismal prognosis.
  • There are other types of GCT that have an intermediate prognosis, such as immature teratoma.
  • Only mature teratomas are curable by surgical resection alone; the other types require adjuvant therapy.
  • To plan a surgical strategy, then eurosurgeon has to acquire enough knowledge of the effect of adjuvant therapies and biological behavior of the GCTs.
  • Germinoma can be cured by low-dose radiotherapy in combination with chemotherapy, and nowadays needs only to be biopsied.
  • Other tumors, such as highly malignant tumors need a sophisticated combination therapy that includes surgery, craniospinal radiation therapy, and intensive chemotherapy.
  • An appropriate neoadjuvant therapy prior toradical surgical removal will remarkably reduce the surgical risk.
  • The goal of treatment should be tightly focused on the reduction of posttreatment sequelae, including surgical morbidity, and not on a complete microsurgical resection.
  • [MeSH-major] Brain Neoplasms. Neoplasms, Germ Cell and Embryonal. Pineal Gland. Pinealoma
  • [MeSH-minor] Combined Modality Therapy. Humans

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  • [Copyright] Copyright (c) 2009 S. Karger AG, Basel.
  • (PMID = 19329863.001).
  • [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] 19
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27. Smith AA, Weng E, Handler M, Foreman NK: Intracranial germ cell tumors: a single institution experience and review of the literature. J Neurooncol; 2004 Jun;68(2):153-9
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  • [Title] Intracranial germ cell tumors: a single institution experience and review of the literature.
  • There is little literature to guide therapy in children and young adults with intracranial germ cell tumors.
  • We present 17 consecutively diagnosed intracranial germ cell tumors at The Children's Hospital, Denver, from 1995 to 2001.
  • Of 17 patients, 3 had considerable delay in diagnosis.
  • Seven had germinoma, three were metastatic at diagnosis.
  • Ten had non-germinomatous germ cell tumors (NGGCT), 5/10 were alpha feto-protein (AFP) positive only, one beta-human chorionic growth (betaHCG) factor positive only, 3 positive for AFP and betaHCG, and 1 malignant teratoma.
  • Therapy for metastatic patients consisted of chemotherapy followed by craniospinal radiation (CSI).
  • Patients with localized disease received chemotherapy followed by focal radiation.
  • Two patients received chemotherapy only, one because she died of sepsis while receiving chemotherapy and one because of neurologic injury incurred during surgery parents elected for no therapy.
  • Three patients have died, one of tumor recurrence, one from a remote complication of surgery and one of sepsis.
  • All five children with only AFP positivity, treated with chemotherapy and focal radiation are alive without evidence of disease at 10, 16, 22, 41 and 41 months.
  • Thus, there is little evidence that CSI is necessary in non-metastatic germinomas and AFP positive NGGCTs when combined chemotherapy and radiation therapy is used.
  • However, complications of delayed diagnosis, surgery and chemotherapy are important causes of mortality, with only one patient dying of tumor.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / pathology. Germinoma / pathology
  • [MeSH-minor] Adult. Child. Combined Modality Therapy. Humans. Retrospective Studies

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  • (PMID = 15218952.001).
  • [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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28. Nakamura H, Takeshima H, Makino K, Kuratsu J: Evaluation of residual tissues after adjuvant therapy in germ cell tumors. Pediatr Neurosurg; 2007;43(2):82-91
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Evaluation of residual tissues after adjuvant therapy in germ cell tumors.
  • OBJECTIVE: Germ cell tumors are the tumors sensitive for adjuvant therapy such as radiotherapy and chemotherapy.
  • We evaluated the pathological findings of these heterogeneous tumors to determine the persistence of residual viable tumor cells after adjuvant therapy.
  • PATIENTS AND METHODS: Between 1988 and 2005, we treated 31 patients with germinoma or germinoma with syncytiotrophoblastic giant cells (STGC) and 15 patients with non-germinomatous malignant germ cell tumors (NGMGCTs).
  • RESULTS: Post-treatment, 3 group 1 and 12 group 2 patients manifested residual tumors.
  • The pathological diagnosis in group 1 patients was mature teratoma, pineal cyst, and fibrous tissue with calcification; in group 2 it was yolk sac tumor (n = 1), immature teratoma (n = 3), mature teratoma (n = 4), and necrosis or fibrous tissue (n = 4).
  • While no group 1 patients manifested tumor cells, MIB-1-positive viable tumor cells were present in resected tissues from one-third of the group 2 patients (3 immature teratomas and 1 yolk sac tumor).
  • CONCLUSION: The absence of viable tumor cells in residual tissue indicates that the combination of cisplatin-based chemo- and radiotherapy was effective in our germinoma patients.
  • On the other hand, in patients with NGMGCTs, these cells persisted despite this combination therapy.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Neoplasm, Residual / diagnosis. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / therapy
  • [MeSH-minor] Adolescent. Adult. Antineoplastic Protocols. Biopsy. Chemotherapy, Adjuvant. Child. Child, Preschool. Combined Modality Therapy. Female. Follow-Up Studies. Giant Cells / pathology. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Radiotherapy, Adjuvant. Survival Rate. Trophoblasts / pathology

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  • [Copyright] Copyright (c) 2007 S. Karger AG, Basel.
  • (PMID = 17337917.001).
  • [ISSN] 1016-2291
  • [Journal-full-title] Pediatric neurosurgery
  • [ISO-abbreviation] Pediatr Neurosurg
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Switzerland
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29. Almubarak S, Gan YC, Steinbok P, Hendson G, Poskitt K, Nadel H, Goddard K, Hukin J: Occurrence of basal ganglia germ cell tumors without a mass. Arch Neurol; 2009 Jun;66(6):789-92
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  • [Title] Occurrence of basal ganglia germ cell tumors without a mass.
  • OBJECTIVE: To report a case series in which basal ganglia calcifications without mass effect proved to be germ cell tumors.
  • INTERVENTIONS: Computed tomography, magnetic resonance imaging, positron emission tomography, biopsy, chemotherapy, and radiation therapy.
  • Fludeoxyglucose F 18-positron emission tomography showed hypometabolism in contrast to malignant glioma.
  • CONCLUSION: Germ cell tumor should be considered in patients with an indolently progressive neurological course, particularly if basal ganglia calcification is present with or without enhancement, asymmetric brain atrophy, or a mass.
  • [MeSH-major] Basal Ganglia / pathology. Basal Ganglia Diseases / pathology. Brain Neoplasms / pathology. Calcinosis / pathology. Neoplasms, Germ Cell and Embryonal / pathology
  • [MeSH-minor] Adolescent. Age Distribution. Age Factors. Antineoplastic Agents / therapeutic use. Asian Continental Ancestry Group. Atrophy / etiology. Atrophy / pathology. Brain Stem / pathology. Child. Dementia / etiology. Disease Progression. Energy Metabolism / physiology. Female. Fluorodeoxyglucose F18. Humans. Magnetic Resonance Imaging. Male. Paresis / etiology. Positron-Emission Tomography. Radiotherapy

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  • (PMID = 19506143.001).
  • [ISSN] 1538-3687
  • [Journal-full-title] Archives of neurology
  • [ISO-abbreviation] Arch. Neurol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0Z5B2CJX4D / Fluorodeoxyglucose F18
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30. Shinoda J, Sakai N, Yano H, Hattori T, Ohkuma A, Sakaguchi H: Prognostic factors and therapeutic problems of primary intracranial choriocarcinoma/germ-cell tumors with high levels of HCG. J Neurooncol; 2004 Jan;66(1-2):225-40
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Prognostic factors and therapeutic problems of primary intracranial choriocarcinoma/germ-cell tumors with high levels of HCG.
  • OBJECTIVE: Primary intracranial choriocarcinoma (PICCC)/germ-cell tumors (GCTs) with high levels of human chorionic gonadotropin (HCG) (PICCC/GCTs with HL-HCG) are rare and malignant.
  • The goal of this study was to report our 3 cases of PICCC/GCTs with HL-HCG and to review the literature to elucidate the clinical problems and prognostic factors and to discuss the therapeutic modalities of this rare tumor.
  • Significance of the differences among survival curves concerning each parameter (age, sex, tumor location, serum HCG/beta-HCG level, precocious puberty, extent of surgery, radiotherapy, chemotherapy, mixture of other non-germinomatous GCT elements and extraneural metastasis) was tested using univariate and multivariate analyses.
  • RESULTS: The median survival time and the 1- and 2-year survival rates were 22 months, 61.2% and 49.8%, respectively.
  • In univariate analysis, male, subtotal removal or more, radiotherapy and chemotherapy were revealed to be significantly good prognostic factors.
  • However, suprasellar region and tumor hemorrhage were poor prognostic factors.
  • Multivariate analysis showed that extent of surgery, radiotherapy and chemotherapy were independent prognostic factors.
  • CONCLUSIONS: Although, we should mind the limitations of this study design because of case selection bias, different treatment protocols and incomplete follow-up of patients, this study led the following results and suggestive conclusions.
  • Tumor hemorrhage and progressive extraneural and cerebrospinal fluid metastasis were characteristic clinical problems of PICCC/GCTs with HL-HCG.
  • In the cases with extremely elevated levels of HCG, biopsy for histological diagnosis may be no longer needed.
  • Initial biopsy and radiotherapy may lead to tumor hemorrhage.
  • To prevent tumor hemorrhage, gross tumor removal followed by radiotherapy and chemotherapy should be aimed for.
  • A few courses of chemotherapy before surgery may prevent metastasis.
  • Stereotactic radiotherapy and high dose chemotherapy may be promising options for treatment.
  • [MeSH-major] Brain Neoplasms / metabolism. Brain Neoplasms / therapy. Choriocarcinoma / metabolism. Choriocarcinoma / therapy. Chorionic Gonadotropin / metabolism. Germinoma / metabolism. Germinoma / therapy

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  • (PMID = 15015791.001).
  • [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
  • [Chemical-registry-number] 0 / Chorionic Gonadotropin
  • [Number-of-references] 82
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31. Nakamura H, Makino K, Kuratsu J: Carbon 11-labeled methionine positron emission tomography for detection of residual viable tumor cells after adjuvant therapy in nongerminomatous malignant germ cell tumors in 2 cases including an autopsy case. Surg Neurol; 2009 Jan;71(1):83-8; discussion 88
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  • [Title] Carbon 11-labeled methionine positron emission tomography for detection of residual viable tumor cells after adjuvant therapy in nongerminomatous malignant germ cell tumors in 2 cases including an autopsy case.
  • BACKGROUND: The treatment of intracranial NGMGCTs is generally based on chemotherapy and radiotherapy.
  • To avoid the potential of tumor recurrence, we normally have the residual mass lesion removed after adjuvant therapy.
  • However, since 1988 we have treated 15 patients with NGMGCT and pathologically evaluated 12 such patients after adjuvant therapy by a new method we have developed and found viable tumor cells in 4 (33%) of 12 patients.
  • Based on our experience, therefore, we feel we have been able to develop a reliable diagnostic tool for confirming the presence or absence of viable tumor cells in residual mass after adjuvant therapy for patients with NGMGCT.
  • We judged it as the recurrence of the tumor.
  • Patient 2 was a 16-year-old girl with an NGMGCT who received combined chemo- and radiotherapy that led to a reduction in the volume of the tumor.
  • To assess whether there were residual viable tumor cells, MET-PET was performed, and it demonstrated no hyper-uptake region in the residual mass.
  • There has not been any tumor recurrence in this patient for more than 2 years.
  • CONCLUSION: In these 2 cases, the increased MET uptake was more specific of tumor tissue and more accurate than MR Gd enhancement.
  • MET-PET may be a useful diagnostic tool for predicting viable tumor cells after adjuvant therapy in patients with NGMGCT, thus allowing further surgical intervention.
  • [MeSH-major] Brain Neoplasms / radionuclide imaging. Brain Neoplasms / therapy. Methionine. Neoplasms, Germ Cell and Embryonal / radionuclide imaging. Neoplasms, Germ Cell and Embryonal / therapy. Radiopharmaceuticals
  • [MeSH-minor] Adolescent. Antineoplastic Agents. Autopsy. Cerebellum / pathology. Cerebellum / radionuclide imaging. Child. Combined Modality Therapy. Endodermal Sinus Tumor / radionuclide imaging. Endodermal Sinus Tumor / therapy. Fatal Outcome. Female. Humans. Magnetic Resonance Imaging. Male. Positron-Emission Tomography. Teratoma / radionuclide imaging. Teratoma / therapy


32. Gardner SL: Application of stem cell transplant for brain tumors. Pediatr Transplant; 2004 Jun;8 Suppl 5:28-32
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  • [Title] Application of stem cell transplant for brain tumors.
  • Brain tumors are the second most common malignancy in children and the most common solid tumor.
  • The majority of children are treated with surgery alone or in combination with radiation and/or chemotherapy.
  • Recently investigators have used high dose chemotherapy with autologous stem cell rescue (ASCR) in patients with malignant brain tumors.
  • This approach has been most successful in chemosensitive tumors including medulloblastoma, supratentorial primitive neuroectodermal tumors (SPNET) and central nervous system germ cell tumors (CNS GCT).
  • In addition, the use of high dose chemotherapy has enabled the reduction and in many cases elimination of radiation therapy to very young children.
  • To date there have been no prospective randomized studies comparing high dose chemotherapy and ASCR with conventional therapy.
  • Radiation therapy is often not an option for patients with recurrent disease and conventional dose chemotherapy rarely if ever results in long-term survival.
  • Unfortunately, the majority of studies using conventional therapy in order to delay irradiation in young children newly diagnosed with malignant brain tumors have been unsuccessful.
  • Although the numbers are small, preliminary data suggest that not only is survival but also quality of life is superior with the use of high dose chemotherapy.
  • In addition, through the use of peripheral blood stem cells and improvements in supportive care, multiple courses of high dose chemotherapy can be administered.
  • High dose chemotherapy with ASCR is a foundation upon which many different types of therapies can be built.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / therapy. Hematopoietic Stem Cell Transplantation
  • [MeSH-minor] Combined Modality Therapy. Humans. Pediatrics

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  • (PMID = 15125703.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Denmark
  • [Number-of-references] 25
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33. Utsuki S, Oka H, Sagiuchi T, Shimizu S, Suzuki S, Fujii K: Malignant transformation of intracranial mature teratoma to yolk sac tumor after late relapse. Case report. J Neurosurg; 2007 Jun;106(6):1067-9
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  • [Title] Malignant transformation of intracranial mature teratoma to yolk sac tumor after late relapse. Case report.
  • The recurrence of intracranial mature teratomas as germ cell tumors of different histological types is rarely reported.
  • The authors describe the first case of the malignant transformation of an intracranial mature teratoma into a yolk sac tumor in a 16-year-old boy who presented with a 1-month history of anorexia and somnolence.
  • Computed tomography images obtained at his second presentation revealed a homogeneously enhanced mass within the third ventricle.
  • The tumor was resected and the results of a histological examination were consistent with a yolk sac tumor.
  • After resection, the patient underwent radiation therapy followed by chemotherapy with cisplatin and etoposide but died of tumor progression 15 months after his second hospitalization.
  • [MeSH-major] Brain Neoplasms / pathology. Endodermal Sinus Tumor / pathology. Endodermal Sinus Tumor / surgery. Teratoma / pathology. Teratoma / surgery
  • [MeSH-minor] Child. Combined Modality Therapy. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Neoplasm Recurrence, Local. Pinealoma / pathology. Pinealoma / surgery. Tomography, X-Ray Computed

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  • (PMID = 17564180.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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34. Matsutani M: Chemoradiotherapy for brain tumors: current status and perspectives. Int J Clin Oncol; 2004 Dec;9(6):471-4
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  • [Title] Chemoradiotherapy for brain tumors: current status and perspectives.
  • Brain tumors growing in the parenchyma of the brain infiltrate diffusely, and the role of surgery is restricted to maximal tumor-bulk removal.
  • Residual tumor cells beyond the surgical margin are not killed by conventional radiation therapy with 60 'Gy.
  • Many clinical trials delivering chemotherapy during radiation therapy and after radiation therapy have been performed, but the results remain poor.
  • Here the author reviews the current treatments of gliomas, malignant lymphomas, medulloblastomas, and germ cell tumors, and their results.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Brain Neoplasms / drug therapy. Brain Neoplasms / radiotherapy. Glioma / drug therapy. Glioma / radiotherapy. Lymphoma / drug therapy. Lymphoma / radiotherapy. Medulloblastoma / drug therapy. Medulloblastoma / radiotherapy. Neoplasms, Germ Cell and Embryonal / drug therapy. Neoplasms, Germ Cell and Embryonal / radiotherapy
  • [MeSH-minor] Clinical Trials as Topic. Combined Modality Therapy. Humans

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  • (PMID = 15616877.001).
  • [ISSN] 1341-9625
  • [Journal-full-title] International journal of clinical oncology
  • [ISO-abbreviation] Int. J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 29
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35. Kan P, Gottfried ON, Blumenthal DT, Liu JK, Salzman KL, Townsend J, Jensen RL: Primary spinal yolk sac tumor with brain metastasis: case report and review of the literature. J Neurooncol; 2006 Jul;78(3):249-53
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  • [Title] Primary spinal yolk sac tumor with brain metastasis: case report and review of the literature.
  • OBJECT: Central nervous system primary germ cell tumors are typically pineal or suprasellar.
  • Primary germ cell tumors of the spinal axis are very rare, with only a few case reports of germinomas and teratomas described in the literature.
  • METHODS: We present the unique case of a 25-year-old woman with an intradural, extramedullary primary yolk sac tumor (YST) at and below the level of the conus medullaris.
  • She was subsequently treated with four cycles of chemotherapy (intravenous cisplatin and etoposide), 40-Gy fractionated focal external beam radiation to the spine, and consolidation with four additional cycles of chemotherapy (intravenous carboplatin, vinblastine, etoposide, and bleomycin).
  • Despite an initial reduction in tumor size and clinical improvement in her neurologic exam, she re-presented a year after surgery with gross enlargement of her spinal tumor and CSF dissemination with metastasis to her brain.
  • Despite further chemotherapy and radiotherapy, the patient died from her disseminated YST.
  • When feasible (no evidence of CSF dissemination, metastasis, or multifocal disease), optimal treatment includes as extensive resection of tumor as possible followed by adjuvant chemotherapy and radiation.
  • The authors review the available literature on the treatment of intracranial malignant germ cell tumors, extrapolated to apply to the much rarer spinal lesions.
  • [MeSH-major] Brain Neoplasms / secondary. Endodermal Sinus Tumor / secondary. Neoplasm Recurrence, Local / pathology. Spinal Neoplasms / pathology

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  • (PMID = 16773223.001).
  • [ISSN] 0167-594X
  • [Journal-full-title] Journal of neuro-oncology
  • [ISO-abbreviation] J. Neurooncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 16
  •  go-up   go-down


36. Soffietti R, Rudā R, Mutani R: Management of brain metastases. J Neurol; 2002 Oct;249(10):1357-69
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  • [Title] Management of brain metastases.
  • Brain metastases occur in 20-40% of patients with cancer and their frequency has increased over time.
  • Lung, breast and skin (melanoma) are the commonest sources of brain metastases, and in up to 15% of patients the primary site remains unknown.
  • Contrast-enhanced MRI is the gold standard for the diagnosis.
  • There are no pathognomonic features on CT or MRI that distinguish brain metastases from primary malignant brain tumors or nonneoplastic conditions: therefore a tissue diagnosis by biopsy should be always obtained in patients with unknown primary tumor before undergoing radiotherapy and/or chemotherapy.
  • Some factors are prognostically important: a high Performance Status, a solitary brain metastasis, an absence of systemic metastases, a controlled primary tumor and a younger age.
  • Symptomatic therapy includes corticosteroids to reduce vasogenic cerebral edema and anticonvulsants to control seizures.
  • In patients with newly diagnosed brain metastases prophylactic anticonvulsants should not be used routinely.
  • The combination of surgery and whole-brain radiotherapy (WBRT) is superior to WBRT alone for the treatment of single brain metastasis in patients with limited or absent systemic disease and good neurological condition.
  • WBRT alone is the treatment of choice in patients with single brain metastasis not amenable to surgery or radiosurgery, and with an active systemic disease, and in patients with multiple brain metastases.
  • The response rate of brain metastases to chemotherapy is similar to the response rate of the primary tumor and extracranial metastases, some tumor types being more chemosensitive (small cell lung carcinoma, breast carcinoma, germ cell tumors).
  • New radiosensitizers and cytotoxic or cytostatic agents, and innovative technique of drug delivery are being investigated.
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / secondary. Brain Neoplasms / therapy
  • [MeSH-minor] Adrenal Cortex Hormones / therapeutic use. Anticonvulsants / therapeutic use. Drug Therapy. Humans. Neurosurgery. Prognosis. Radiosurgery. Radiotherapy. Thromboembolism / therapy. Treatment Outcome

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  • (PMID = 12382150.001).
  • [ISSN] 0340-5354
  • [Journal-full-title] Journal of neurology
  • [ISO-abbreviation] J. Neurol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Adrenal Cortex Hormones; 0 / Anticonvulsants
  • [Number-of-references] 134
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37. Kebudi R, Ayan I, Görgün O, Ağaoğlu FY, Vural S, Darendeliler E: Brain metastasis in pediatric extracranial solid tumors: survey and literature review. J Neurooncol; 2005 Jan;71(1):43-8
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  • [Title] Brain metastasis in pediatric extracranial solid tumors: survey and literature review.
  • OBJECTIVES: Brain is a rare site of metastasis in most extracranial pediatric solid tumors.
  • The aim of this study is to investigate the incidence, treatment, prognosis of brain metastasis in extracranial pediatric malignant tumors in a single institution and to review the literature.
  • Patients with parenchymal metastases in the brain were assessed.
  • RESULTS: Sixteen (10 female, 6 male) of 1100 patients (1.45%) with extracranial solid tumors developed brain metastases.
  • The diagnosis was sarcomas in 12 patients: 5 osteosarcomas, 4 Ewing's sarcoma family tumors, 1 rhabdomyosarcoma, 1 clear cell sarcoma of the soft tissue, 1 alveolar soft part sarcoma.
  • Two patients had Wilms' tumor and two had germ cell tumors.
  • Four patients (25%) had brain metastasis at diagnosis.
  • Twelve (75%) developed brain metastasis during therapy or relapse at a median duration of 16 (1-70) months from initial diagnosis.
  • All patients had metastases to various sites, mostly lung, at the time the brain metastases were detected.
  • Treatment included surgery, followed by postoperative radiotherapy (RT) and chemotherapy (CT) in 1, S and RT in 1, S in 1, RT and CT in 6, RT in 1, CT in 1 and no treatment in 5.
  • Only one patient with alveolar soft part sarcoma is alive with disease 20 months from diagnosis of brain metastasis.
  • All other patients died at a median time of 2 months (2 days-6 months) from the time of brain metastasis.
  • CONCLUSIONS: Children with metastatic cancer who develop headaches or any other neurologic symptom should be investigated for possible brain metastasis.
  • Although, the outcome for these patients is dismal in this series and in the literature; reports of long term survival in a few cases with Wilms' tumor, osteosarcoma and alveolar soft part sarcoma who had isolated brain metastasis, suggest that a subset of patients may benefit from therapy.
  • [MeSH-major] Brain Neoplasms / epidemiology. Brain Neoplasms / secondary. Sarcoma / epidemiology. Sarcoma / secondary
  • [MeSH-minor] Adolescent. Antineoplastic Agents / therapeutic use. Bone Neoplasms / epidemiology. Bone Neoplasms / secondary. Bone Neoplasms / therapy. Child. Child, Preschool. Female. Humans. Infant. Lung Neoplasms / epidemiology. Lung Neoplasms / secondary. Lung Neoplasms / therapy. Male. Mediastinal Neoplasms / epidemiology. Mediastinal Neoplasms / secondary. Mediastinal Neoplasms / therapy. Neoplasms, Germ Cell and Embryonal / epidemiology. Neoplasms, Germ Cell and Embryonal / secondary. Neoplasms, Germ Cell and Embryonal / therapy. Prognosis. Radiotherapy, Adjuvant. Survival Analysis. Wilms Tumor / epidemiology. Wilms Tumor / secondary. Wilms Tumor / therapy

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  • (PMID = 15719274.001).
  • [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
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 43
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38. Bell S: Breaking down barriers to treat a patient with a germinoma: a case study. J Neurosci Nurs; 2004 Aug;36(4):195-9
MedlinePlus Health Information. consumer health - Brain Tumors.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Germinomas are the most common type of germ cell tumor occurring commonly before the second decade of life.
  • Because of the radiosensitivity of germinomas, traditional treatment following diagnosis has been conventional radiotherapy.
  • The desire to defer radiotherapy to avoid the delayed neurocognitive effects has led researchers to investigate the use of up front chemotherapy.
  • A major limitation in using chemotherapy for brain tumors has been the inability to deliver drugs across the blood brain barrier.
  • The blood brain barrier consortium has developed chemotherapy protocols for patients with malignant brain tumors through the use of reversible osmotic opening of the blood brain barrier.
  • The mannitol infusion is followed by both intraarterial and intravenous chemotherapy.
  • By administering chemotherapy in conjunction with blood brain barrier disruption, drug delivery to the tumor and the brain around tumor is increased.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / pharmacokinetics. Blood-Brain Barrier / drug effects. Brain Neoplasms / drug therapy. Germinoma / drug therapy
  • [MeSH-minor] Adult. Drug Delivery Systems. Female. Humans. Magnetic Resonance Imaging / methods

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  • (PMID = 15366544.001).
  • [ISSN] 0888-0395
  • [Journal-full-title] The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
  • [ISO-abbreviation] J Neurosci Nurs
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 4
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39. Blakeley JO, Grossman SA: Management of pineal region tumors. Curr Treat Options Oncol; 2006 Nov;7(6):505-16
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  • This diversity necessitates accurate histologic diagnosis to allow rational therapeutic planning.
  • Whereas certainty of the histologic diagnosis is now a requirement for treatment in Western nations, some Asian centers continue to recommend a test dose of radiation therapy based on the high incidence of germinoma in those countries.
  • This approach provides adequate tissue for diagnosis, may be curative in low-grade tumors, and may substantially improve survival in patients with malignant tumors.
  • Radiation therapy is the first-line therapy for germinomas.
  • Although the optimal radiation dosage and volume have not been decided, the current Children's Oncology Group trial may offer definitive evidence to address this dilemma in germ cell tumors.
  • Evidence of CSF seeding requires craniospinal radiation and adjuvant chemotherapy regardless of tumor type.
  • Diagnosis of any of the malignant tumors (non-germ cell tumors, pineoblastomas, and parenchymal tumors of intermediate determination) also requires craniospinal radiation (with local tumor doses of at least 50 Gy) and adjuvant chemotherapy (generally platinum based).
  • [MeSH-major] Brain Neoplasms / diagnosis. Brain Neoplasms / therapy. Pineal Gland
  • [MeSH-minor] Combined Modality Therapy. Glioma / diagnosis. Glioma / pathology. Glioma / therapy. Humans. Magnetic Resonance Imaging. Neoplasms, Germ Cell and Embryonal / diagnosis. Neoplasms, Germ Cell and Embryonal / pathology. Neoplasms, Germ Cell and Embryonal / therapy. Pinealoma / diagnosis. Pinealoma / pathology. Pinealoma / therapy

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  • (PMID = 17032562.001).
  • [ISSN] 1527-2729
  • [Journal-full-title] Current treatment options in oncology
  • [ISO-abbreviation] Curr Treat Options Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 59
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40. Bhat SR, Goodwin TL, Burwinkle TM, Lansdale MF, Dahl GV, Huhn SL, Gibbs IC, Donaldson SS, Rosenblum RK, Varni JW, Fisher PG: Profile of daily life in children with brain tumors: an assessment of health-related quality of life. J Clin Oncol; 2005 Aug 20;23(24):5493-500
ClinicalTrials.gov. clinical trials - ClinicalTrials.gov .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Profile of daily life in children with brain tumors: an assessment of health-related quality of life.
  • RESULTS: One hundred thirty-four patients (73 male; mean age +/- standard deviation, 11.8 +/- 5.4 years; 55 had low-grade glioma, 32 had medulloblastoma/primitive neuroectodermal tumor/embryonal tumor, 17 had malignant astrocytoma, nine had germ-cell tumor, and 21 had other types of tumors) were assessed, each in less than 20 minutes.
  • Children receiving radiation therapy (XRT) but no chemotherapy had significantly lower total, psychosocial, emotional, and social functioning than those receiving other treatments, including XRT plus chemotherapy.
  • Children receiving XRT fare worse overall; chemotherapy added to XRT does not seem to worsen HRQOL.
  • [MeSH-major] Brain Neoplasms / physiopathology. Brain Neoplasms / psychology. Quality of Life

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  • [CommentIn] J Clin Oncol. 2005 Aug 20;23(24):5424-6 [16110000.001]
  • (PMID = 16110009.001).
  • [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; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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41. Pitskhelauri DI, Konovalov AN, Azizian VN, Kornienko VN, Korshunov AG, Melikian AG, Loshakov VA, Serova NK: [Iatrogenic metastasis of pineal tumors]. Zh Vopr Neirokhir Im N N Burdenko; 2004 Oct-Dec;(4):28-33; discussion 33-4
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Malignant pineal tumors (PT) tend to metastasize.
  • Metastasis occurred: a) along the surgical approach path after tumor removal in 2 cases;.
  • The sources of metastases were pineoblastoma (n = 1), malignant teratoma (n = 1), germinoma (n = 1), and malignant germ-cell tumor of unknown genesis (n = 1).
  • To prevent this complication due to high-grade PT, such as malignant germ-cell tumors and pineoblastomas, radiation of the whole brain, besides the sites of a tumor should be performed and, in some cases, in combination with chemotherapy.
  • [MeSH-major] Brain Neoplasms / pathology. Neurosurgical Procedures / adverse effects

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  • (PMID = 15724549.001).
  • [ISSN] 0042-8817
  • [Journal-full-title] Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko
  • [ISO-abbreviation] Zh Vopr Neirokhir Im N N Burdenko
  • [Language] rus
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Russia
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42. Oi S, Shibata M, Tominaga J, Honda Y, Shinoda M, Takei F, Tsugane R, Matsuzawa K, Sato O: Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: a prospective study. J Neurosurg; 2000 Aug;93(2):245-53
MedlinePlus Health Information. consumer health - Endoscopy.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • METHODS: If the tumor markers alpha-fetoprotein and human chorionic gonadotropin were not detected in serum and there was significant ventricular dilation visualized on neuroimages, neuroendoscopic surgery was first applied for tumor debulking with tissue diagnosis and gross morphological analysis of the tumor and the intraventricular structures, followed by third ventriculostomy.
  • For treatment of germinomas and pineoblastomas, if no tumor dissemination was confirmed by pre-, intra-, or postoperative findings, stereotactic radiotherapy or radiosurgery was performed after one course of chemotherapy with the ICE regimen (isofomid, cisplatin, and etoposide) and followed by two additional courses of chemotherapy.
  • For treatment of malignant germ cell tumors, after extensive surgery, adjuvant chemotherapy with the ICE regimen was performed in three courses in all cases.
  • Then radiotherapy was started using various methods, depending on the evidence of tumor dissemination.
  • For treatment of teratomatous and neuroectodermal tumors other than pineoblastomas, extensive surgical removal was performed.
  • As for adjuvant therapy, if the tumor was a low-grade glioma or if the patient was younger than 5 years of age, postoperative treatment did not include radiotherapy.
  • If the tumor was a malignant teratoma or high-grade glioma, conventional focal radiotherapy was performed, followed by chemotherapy with ICE for 1 year.
  • Neuroendoscopic biopsy with tumor debulking offered enough material for tissue diagnosis, including immunohistochemical analysis and, in one case, revealed evidence of tumor dissemination undetectable on neuroimaging.
  • Favorable therapeutic outcomes were obtained in all cases of germinoma and pineoblastoma, with follow-up periods ranging from 24 months to 6.5 years.
  • CONCLUSIONS: Our minimally invasive preferential regimen clarified the precise indication for neuroendoscopic procedures, and the majority of our patients with dilated ventricles and no evidence of tumor markers were treated satisfactorily with effective neuroendoscopic procedures as the initial procedure, avoiding unnecessary craniotomy and radiotherapy and promising excellent therapeutic outcomes.
  • The treatment for malignant pineal region tumors remains a subject for further study.
  • [MeSH-major] Brain Neoplasms / surgery. Endoscopy. Minimally Invasive Surgical Procedures. Pineal Gland / surgery. Pinealoma / surgery. Radiosurgery
  • [MeSH-minor] Adolescent. Adult. Aged. Biomarkers, Tumor / analysis. Chemotherapy, Adjuvant. Child. Female. Glioma / pathology. Glioma / surgery. Humans. Male. Middle Aged. Neoplasm Staging. Prospective Studies. Radiotherapy, Adjuvant. Risk Factors. Treatment Outcome

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  • (PMID = 10930010.001).
  • [ISSN] 0022-3085
  • [Journal-full-title] Journal of neurosurgery
  • [ISO-abbreviation] J. Neurosurg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
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43. Konovalov AN, Pitskhelauri DI: Principles of treatment of the pineal region tumors. Surg Neurol; 2003 Apr;59(4):250-68

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Principles of treatment of the pineal region tumors.
  • BACKGROUND: A pineal region tumor is an uncommon deep-seated, heterogeneous group of mass lesions of the brain, and the management strategy of any types of these tumors remains controversial.
  • In more than 330 cases the tumor was removed.
  • All of them had verified tumor histology, excluding only five cases in which stereotactic biopsy procedures were uninformative.
  • There are four main groups of tumors: the germ cell tumors-87 (31%); the pineal parenchymal tumors-75 (27%); the glial tumors-77 (27%); and miscellaneous-43 (15%).
  • There were 255 surgical procedures for tumor removal performed in 244 and stereotactically guided biopsies in 61 patients, 168 (58%) with obstructive hydrocephalus who underwent cerebrospinal fluid shunting.
  • Radiation therapy was administered in 145 (51%) and chemotherapy in 16 patients.
  • A total tumor removal was achieved in 148 operations (58%), subtotal in 74 (29%) and partial in 33 (13%).
  • The projected 5-year and 10-year survival rates for patients with malignant pineal tumors, who received irradiation after tumor resection or underwent radiation therapy alone, were: 95% and 88% for pure germinomas, 80% and 50% for high grade gliomas, 44% and 0% for malignant pineal parenchymal tumors, and 20% and 0% for malignant germ cell tumors, respectively.
  • Malignant tumors should be treated with aggressive resection followed with irradiation and chemotherapy.
  • Pure germinomas, which are exquisitely radiosensitive, can be cured by conventional radiation therapy alone.
  • [MeSH-minor] Adolescent. Adult. Animals. Biopsy. Child. Child, Preschool. Female. Humans. Hydrocephalus / etiology. Male. Middle Aged. Prognosis. Retrospective Studies. Stereotaxic Techniques. Survival. Treatment Outcome

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  • (PMID = 12748006.001).
  • [ISSN] 0090-3019
  • [Journal-full-title] Surgical neurology
  • [ISO-abbreviation] Surg Neurol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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44. Kohyama S, Uematsu M, Ishihara S, Shima K, Tamai S, Kusano S: An experience of stereotactic radiation therapy for primary intracranial choriocarcinoma. Tumori; 2001 May-Jun;87(3):162-5
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  • [Title] An experience of stereotactic radiation therapy for primary intracranial choriocarcinoma.
  • We report on a patient with choriocarcinoma in the pineal region who was successfully treated with stereotactic radiation therapy (SRT).
  • The increased level of serum human chorionic gonadotropin (HCG) was lowered during chemotherapy with etoposide, cisplatin, and ifosfamide.
  • However, HCG was not normalized and magnetic resonance images still showed an enhanced tumor mass with gadolinium.
  • The patient underwent SRT of 40 Gy at an 80% isodose line per 10 fractions over two weeks, followed by conventional craniospinal irradiation of 32.4 Gy.
  • The level of HCG dropped below the detection limit.
  • The patient has been in good condition for more than four years after the completion of treatment, without any signs of recurrence.
  • We propose SRT as a valid treatment option for malignant germ cell tumors in the pineal region.
  • [MeSH-major] Brain Neoplasms / surgery. Choriocarcinoma / surgery. Radiosurgery
  • [MeSH-minor] Adult. Humans. Immunohistochemistry. Magnetic Resonance Imaging. Male. Tomography, X-Ray Computed. Treatment Outcome

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  • (PMID = 11504371.001).
  • [ISSN] 0300-8916
  • [Journal-full-title] Tumori
  • [ISO-abbreviation] Tumori
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
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45. Moiyadi A, Jalali R, Kane SV: Intracranial growing teratoma syndrome following radiotherapy--an unusually fulminant course. Acta Neurochir (Wien); 2010 Jan;152(1):137-42
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  • INTRODUCTION: Residual radiologically progressive masses following multimodality treatment of malignant mixed intracranial germ cell tumors are described.
  • RESULTS: A review of the scanty tissue was suggestive of a pineal parenchymal tumor, and hence radiation was planned.
  • After just ten fractions, he developed rapid neurological deterioration.
  • Repeat imaging raised a possibility of a teratomatous tumor.
  • CONCLUSION: Though a growing teratoma syndrome has been described following chemotherapy, no such report while on radiation exists.
  • [MeSH-major] Brain Neoplasms / etiology. Neoplasms, Radiation-Induced. Pinealoma / radiotherapy. Teratoma / etiology
  • [MeSH-minor] Child, Preschool. Fatal Outcome. Humans. Magnetic Resonance Imaging. Male. Neurosurgical Procedures. Tomography, X-Ray Computed

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  • (PMID = 19404574.001).
  • [ISSN] 0942-0940
  • [Journal-full-title] Acta neurochirurgica
  • [ISO-abbreviation] Acta Neurochir (Wien)
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] Austria
  • [Number-of-references] 23
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46. Halperin EC: Neonatal neoplasms. Int J Radiat Oncol Biol Phys; 2000 Apr 1;47(1):171-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • PURPOSE: To describe neoplasms diagnosed in children </= 28 days of age along with their treatment, associated congenital anomalies, and the long-term consequences of the diagnoses and treatments.
  • METHODS AND MATERIALS: Utilizing autopsy records, a computerized tumor registry, and medical records, we identified patients and stillborns at Duke University Medical Center (DUMC) diagnosed with neoplasms at </= 28 days of age between 1930 and 1998.
  • The 20 patients identified via the computerized registry system for 1980-1998 constitute 2% (20/925) of all neoplasms seen in patients </= 16 years of age over this same time period at DUMC.
  • The histologic diagnoses were teratoma/germ cell tumor (n = 8, 35%), neuroblastoma (n = 5, 22%), retinoblastoma (n = 4, 17%), primary central nervous system (CNS) tumor (n = 3, 13%), and one case each of rhabdomyosarcoma, glossal glial choristoma, and hemangioma in the setting of Kasabach-Merritt Syndrome.
  • Of the eight teratoma/germ cell tumor patients, 6 were female (75%) and 2 male (25%).
  • There was one malignant germ cell tumor, 2 immature teratomas, and 5 teratomas.
  • The one patient with malignant germ cell tumor, treated with surgery and chemotherapy, died.
  • Two were treated with surgery + chemotherapy + radiotherapy; two with surgery + chemotherapy; and one with surgery alone.
  • A child with a dumbbell neuroblastoma, treated with surgery and chemotherapy, is paraplegic.
  • The two children with trilateral retinoblastoma died after therapy with surgery, craniospinal and orbital irradiation, and chemotherapy.
  • Two children with bilateral disease are long-term survivors: one treated with radiotherapy + chemotherapy and one with radiotherapy alone.
  • The histologies were glioblastoma multiforme, anaplastic astrocytoma, and malignant mixed oligodendroglioma.
  • Two of the patients are long-term survivors after surgery + chemotherapy.
  • Six children received eight courses of radiation therapy: 2 for Stage 4S neuroblastoma with respiratory compromise from an enlarging liver and 4 for retinoblastoma.
  • The two infants with trilateral retinoblastoma received two courses of irradiation each: one of the treatment of intraocular tumor and a second, at an older age, for the pineal tumor.
  • CONCLUSION: The most common neonatal neoplasm histologic diagnoses are teratoma/germ cell tumor, neuroblastoma, and retinoblastoma.
  • Radiation therapy is administered infrequently in a population highly susceptible to late ill effects.
  • When radiotherapy is required, anesthesia may be repetitively administered to aid in reproducible treatment.
  • [MeSH-minor] Anesthesia. Brain Neoplasms / epidemiology. Brain Neoplasms / pathology. Brain Neoplasms / therapy. Female. Follow-Up Studies. Hemangioma / epidemiology. Hemangioma / pathology. Hemangioma / therapy. Humans. Infant, Newborn. Male. Neuroblastoma / epidemiology. Neuroblastoma / pathology. Neuroblastoma / therapy. Registries. Retinoblastoma / epidemiology. Retinoblastoma / pathology. Retinoblastoma / therapy. Survivors. Teratoma / epidemiology. Teratoma / pathology. Teratoma / therapy

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  • (PMID = 10758320.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] UNITED STATES
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47. Mandat T, Roszkowski M, Barszcz S, Podgórski JK, Jurkiewicz E: [Neuroendoscopy in the treatment of third ventricular hydrocephalus accompanying tumors of the posterior part of the third ventricle in children]. Neurol Neurochir Pol; 2002 Jul-Aug;36(4):711-22
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Neuroendoscopy in the treatment of third ventricular hydrocephalus accompanying tumors of the posterior part of the third ventricle in children].
  • In 22 cases benign tectal mass (BTM) and 10 malignant neoplasms (including 9 germ cell tumours and 1 ependymoma) were diagnosed.
  • 8 patients with malignant neoplasms after initial chemotherapy underwent residual tumor excision (more than 3 months after ETVs) and in two of them the CFS meningeal tumor spreads were detected.
  • 3 of them were children with benign tectal masses and 3 with malignant tumours.
  • The reason of failure in 2 cases was associated with meningeal tumor dissemination, and in one with postoperative bleeding after surgical tumor excision (communicating hydrocephalus).
  • Five out of 6 patients underwent shunt placements and in 1 case with late ventriculostomy occlusion another endoscopic procedure (after 26 months) was successfully performed.
  • CONCLUSIONS: The endoscopic third ventriculostomy was an efficient method to control non-communicating hydrocephalus in children with posterior part of the third ventricle brain tumours.
  • The PC MR flow study was a useful diagnostic tool in the stomy patency evaluation and in further treatment planning in cases of failures.
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Male. Treatment Outcome. Ventriculoperitoneal Shunt

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  • (PMID = 12418136.001).
  • [ISSN] 0028-3843
  • [Journal-full-title] Neurologia i neurochirurgia polska
  • [ISO-abbreviation] Neurol. Neurochir. Pol.
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Poland
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