Radiation Oncology/CNS/NGGCT

Nongerminomatous Germ Cell Tumors (NGGCTs)


 * POG 9530 (1997-1999) -- response-based RT
 * Phase II. 14 NGGCT patients and/or germinomas with elevated AFP/bHCG (and 12 pure germinoma patients - not discussed here). Age >3 years. Germinoma treated with cisplatin/etoposide and vincristine/cyclophosphamide x4 cycles. If CR, primary site RT 30.6 Gy; if PR primary site RT 50.4 Gy with 2cm margin (3D-CRT) or 0.5cm margin (SRT). If disseminated disease and CR, CSI 30.6 Gy; if PR CSI 36 Gy
 * 2007 PMID 16598761 -- "Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: a report from the Children's Oncology Group." (Kretschmar C, Pediatr Blood Cancer. 2007 Mar;48(3):285-91.)
 * Outcome: 5/9 CR/PR after chemo; 11/14 progression-free at median 4.8 years
 * Conclusion: Response (55%) and survival encouraging