Treatment and Response
Treatment approaches are summarized in Table 3. Of the patients with
germinomas (n=16), nine (56.3%) underwent surgical biopsy and seven
(46.7%) underwent subtotal resection (STR). Ten patients (62.5%)
received chemotherapy. All chemotherapies were platinum-based. Only one
patient received chemotherapy alone. Of the patients who underwent
combined chemotherapy/RT, all patients received chemotherapy prior to
RT. Fourteen patients (87.5%) received RT; two patients (12.5%)
received craniospinal irradiation (CSI) (mean 2370c Gy), three (18.8%)
received whole brain radiotherapy (WBRT) (mean 29.3 Gy), four (25%)
received whole ventricle irradiation (WVI) (mean 27 Gy), four (25%)
received focal RT (mean 30 Gy) and one (6.3%) received an unspecified
regimen. Four patients (25%) received primary site boost (mean total
dose 43.3 Gy; three WVI, one CSI). Complete response (CR) was achieved
in nine patients (56.3%) following therapy.
Of the patients with NGGCTs (n=16), five (31.3%) underwent surgical
biopsy (three YSTs, one mixed GCT, one embryonal carcinoma), three
(18.8%) underwent gross total resection (GTR) (two YSTs, one STGC) and
four (25%) underwent STR (two YSTs, one embryonal carcinomas, one mixed
GCT). Fifteen patients (93.4%) received chemotherapy; 10 (62.5%)
received combined chemotherapy/RT (three YSTs, three mixed GCTs, one
STGC, three unspecified) and four (25%) received chemotherapy-only (two
YSTs, two embryonal carcinomas). All chemotherapies were platinum-based.
One patient received no adjuvant therapy (one YST). Ten patients
(62.5%) received RT; four (25%) received CSI (mean 22.5 Gy), two
(12.5%) received WBRT (mean 25.5 Gy), one (6.3%) received WVI (dose
unreported), two (12.5%) received focal RT (mean 45.6 Gy) and one
(6.3%) received an unspecified regimen. Three patients (18.8%)
received primary site boost (mean total dose 27 Gy). Complete response
was achieved in 12 patients (75%) following therapy.
Of the patients with teratomas (n=8), three (37.5%) underwent surgical
biopsy-only (one immature teratoma, two unspecified teratomas) and five
(62.5%) underwent GTR (four immature teratomas, one mature teratoma).
Adjuvant therapy was chemotherapy-only (three immature teratomas) or
RT-only (one unspecified teratoma). All chemotherapy regimens were
platinum-based. Five patients (62.5%) achieved CR following therapy.