GCT-23. MULTI-INSTITUTIONAL ANALYSIS OF TREATMENT MODALITIES IN BASAL GANGLIA AND THALAMIC GERMINOMA. (4th December 2020)

• Record Type: Journal Article
• Authors: Graham, Richard T; Abu-Arja, Mohammad H; Stanek, Joseph; Bartels, Ute; Cappellano, Andrea; Chi, Susan; Cooney, Tabitha; Dhall, Girish; Finlay, Jonathan L; Fisher, Michael J; Friedman, Gregory; Gajjar, Amar; Gauvain, Karen; Hoffmann, Lindsey M; Hukin, Juliette; Margol, Ashley; Mueller, Sabine; Navalkele, Pournima; Ronsley, Rebecca; Villeneuve, Stephanie; Yeo, Kee Kiat; Su, Jack M; Gottardo, Nicholas G; Allen, Jeffrey; Packer, Roger; AbdelBaki, Mohamed
• Is Part Of: Neuro-oncology. Volume 22(2020)Supplement 3
• Page Start: iii332
• Page End: iii332
• Publication Date: 2020-12-04
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noaa222.243
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: BACKGROUND: Central nervous system (CNS) germinomas are radiotherapy (RT)-sensitive tumors with excellent survival. Current treatment strategies combine chemotherapy with RT to reduce the field and dose of RT. There is no standard treatment for germinomas originating in the basal ganglia/thalami (BGTG) given their rarity and poorly-defined imaging characteristics. Craniospinal (CSI), whole brain (WBI), whole ventricle (WVI), and focal RT have been previously utilized; however, the optimal strategy remains unclear. METHODS: Retrospective multi-institutional analysis was conducted across 18 institutions in four countries. RESULTS: For 46 cases with non-metastatic BGTG, the event-free survival (EFS) was 86.9% at both 5 and 10 years, while overall survival (OS) was 100%, and 95.7% respectively at 5 and 10 years. Median RT dose and range for the various treatment volumes were as follows: CSI (n=10): 2340 cGy (1980–3060 cGy), WBI (n=8): 2340 (1800–3000 cGy), WVI (n=14): 2340 cGy (1800–2550 cGy), focal (n=9): 3600 cGy (3060–5400 cGy). There was no statistically significant difference in the EFS based on RT modality (p=0.57), but EFS for subjects with CSI and WBI were both 100%. The three subjects who received chemotherapy alone had significantly lower EFS than those who received chemotherapy and RT (p=0.001), but were salvageable with RT. CONCLUSION: In the largest study to date for BGTG, there were no significant differences in outcomes between patients who received CSI, WBI, WVI or focal RT. This group of patients should be included in future prospective clinical trials, and a more limited RT field may be considered.