Korean J Pediatr.  2005 Feb;48(2):186-190.

Responses and Toxicities of Risk-adapted Chemotherapy in Pediatric Intracranial Germ Cell Tumors

• You DK
• Lee SH
• Yoo KH
• Sung KW
• Lim DH
• Shin HJ
• Koo HH

Abstract

PURPOSE
The purpose of this study was to evaluate the responses and toxicities of risk-adapted chemotherapy in pediatric intracranial germ cell tumors(IC-GCT).
METHODS
Fourteen patients who were diagnosed as IC-GCT from October 2002 to December 2003 received chemotherapy as an initial treatment modality. The low risk(LR) group was defined as follows: Pure germinoma and normal AFP level. Beta-hCG level 50 mIU/mL or less. The others belonged to the high risk(HR) group. Chemotherapy was composed of cisplatin, cyclophosphamide, etoposide and vincristine. Double doses of cisplatin and cyclophosphamide was used in HR patients.
RESULTS
Pathologic confirmation was done in all but one. Median age at diagnosis was 11.6 yr (1.2-18.7 yr), and nine patients belonged to the HR group. Tumor markers were normalized after chemotherapy in all patients whose tumor markers had been elevated. Four LR patients(80 percent) and seven HR patients(77.8 percent) showed complete response(CR) at the end of chemotherapy. An additional two of the three patients with partial response(PR) achieved CR after radiation therapy (RT), and the remaining one relapsed before RT. Four LR and all HR patients experienced infectious episodes that required hospitalization. Four of the nine HR patients(44.4 percent) suffered from tinnitus, three of whom developed sensorineural hearing loss. All but one are surviving, event-free, with a median follow-up of 13.9 mo(8.1-22.3 mo).
CONCLUSION
Risk-adapted cisplatin-based chemotherapy was effective even in HR patients, but regimen modification seems to be necessary to avoid an unacceptably high toxicity rate.

Keyword

Intracranial germ cell tumor; Chemotherapy; Responses; Toxicities

MeSH Terms

Cisplatin
Cyclophosphamide
Diagnosis
Drug Therapy*
Etoposide
Follow-Up Studies
Germ Cells*
Germinoma
Hearing Loss, Sensorineural
Hospitalization
Humans
Neoplasms, Germ Cell and Embryonal*
Tinnitus
Biomarkers, Tumor
Vincristine
Cisplatin
Cyclophosphamide
Etoposide
Vincristine