Phase II trial of pathology-based tripartite treatment stratification for patients with CNS germ cell tumors: A long-term follow-up study
Rattachement africain : jp, us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: A previous Phase II clinical trial, conducted from 1995 to 2003, evaluated CNS germ cell tumors (GCTs) using a three-group treatment stratification based on histopathology. The primary objective of the study was to assess the long-term efficacy of standardized treatment regimens, while the secondary objective focused on identifying associated long-term complications. METHODS: A total of 228 patients were classified into 3 groups for treatment: germinoma (n = 161), intermediate prognosis (n = 38), and poor prognosis (n = 28), excluding one mature teratoma case. Treatment involved stratified chemotherapy regimens and varied radiation doses/coverage. Clinical data was retrospectively analyzed at a median follow-up of 18.5 years. RESULTS: The treatment outcomes for germinoma, with or without syncytiotrophoblastic giant cells, were similar. The 10- and 20-year event-free survival rates for the germinoma, intermediate, and poor prognosis groups were 82/76/49% and 73/66/49%, respectively. Overall survival (OS) rates were 97/87/61% at 10 years and 92/70/53% at 20 years. Germinomas in the basal ganglia, treated without whole-brain radiation therapy (WBRT), frequently relapsed but were effectively managed with subsequent WBRT. Deaths in germinoma cases had varied causes, whereas deaths in the poor prognosis group were predominantly disease-related. Nineteen treatment-related complications were identified in 16 patients, with cumulative event rates of 1.9% at 10 years and 11.3% at 20 years. OS rates at 1 and 2 years post-relapse for tumors initially classified as germinoma, intermediate, and poor prognosis were 94/88/18% and 91/50/9%, respectively. CONCLUSIONS: Initial treatment intensity is crucial for managing non-germinomatous GCTs, while long-term follow-up for relapse and complications is imperative in germinomas. Irradiation extending beyond the immediate tumor site is essential for basal ganglia germinomas. Addressing relapse in non-germinomatous GCT remains a significant challenge.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Phase II trial of pathology-based tripartite treatment stratification for patients with CNS germ cell tumors: A long-term follow-up study
- Date Crossref
- 02/11/2024
- Éditeur
- Oxford University Press (OUP)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of Tokyo Hospital pays non établi dans la noticeÉtablissement de santé
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Saitama International Medical Center pays non établi dans la noticeÉtablissement de santé
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Saitama Medical University Department of Neuro-Oncology/Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Saitama Medical University Hospital pays non établi dans la noticeÉtablissement de santé
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Yamaguchi University pays non établi dans la noticeUniversité ou école supérieure
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Hokkaido University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Tohoku University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Yamagata University pays non établi dans la noticeUniversité ou école supérieure
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Niigata University Department of Neurosurgery pays non établi dans la noticeUniversité ou école supérieure
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Kanazawa University pays non établi dans la noticeUniversité ou école supérieure
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Kanazawa Medical University pays non établi dans la noticeUniversité ou école supérieure
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University of Tsukuba pays non établi dans la noticeUniversité ou école supérieure
University of Tokyo Hospital, Saitama International Medical Center et Department of Neuro-Oncology/Neurosurgery — Saitama Medical University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.