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GERM-06. REDUCED RADIOTHERAPY DOSE AND VOLUME FOLLOWING CHEMOTHERAPY FOR INTRACRANIAL GERMINOMA WITH B-HCG LEVEL < 200 MIU/ML: PRELIMINARY RESULTS OF SMC G-13 TRIAL

ABSTRACT: Abstract PURPOSE We performed a prospective single arm trial (NCT02782754) to investigate whether pre-RT chemotherapy could reduce the necessary dose and volume of RT while preventing relapse/progression of intracranial germinoma with b-HCG level < 200 mIU/mL. METHODS A total of 32 patients who were diagnosed with intracranial germinoma with b-HCG level < 200 mIU/mL were enrolled in this study. Four cycles of chemotherapy were given prior to RT. A 18 Gy of craniospinal RT for M+ tumors, whole brain RT for basal ganglia tumor, otherwise whole ventricle RT followed by 12.6 Gy of local RT to the primary site was administered following pre-RT chemotherapy. RESULT The site of primary tumor was suprasellar in 10, pineal in 10, bifocal in 11, and basal ganglia in 1. Ten patients had leptomeningeal seedings. Toxicity during chemotherapy was mild except bone marrow suppression. Pre-RT tumor status was CR in 26 patients, PR in 4, MR in 1, and not evaluated yet in 1. All patients remain event free during a median follow-up of 3.1 years (rage, 0.2-5.1) from diagnosis. Late effects from chemo-radiotherapy evaluated in 14 patients at 3 years from off-therapy were not significant except neuroendocrine dysfunction in 10 patients who already had neuroendocrine dysfunction at diagnosis and avascular necrosis of hip in one patient. CONCLUSION Pre-RT chemotherapy can reduce the necessary dose and volume of RT. A longer follow-up is needed to assess whether our strategy will ultimately reduce overall late adverse effects without jeopardizing survival.

SUBMITTER: Lee J

PROVIDER: S-EPMC6012071 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Vinblastine monotherapy induction prior to radiotherapy for patients with intracranial germinoma during the COVID-19 pandemic.

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