放射治疗颅内生殖细胞瘤的长期结果

目的:评价单独放射治疗颅内生殖细胞瘤的长期治疗结果。方法:对颅内生殖细胞瘤11例采用放射治疗,经病理证实5例(3例生殖细胞瘤,2例非生殖细胞瘤),6例临床和影像诊断以及诊断性放疗证实对放疗敏感。诊断时平均年龄16.8岁(10～32岁),全脑或全中枢照射+局部补量照射,肿瘤平均剂量52.2Gy(范围50～60Gy)。所有病人均未接受化疗。结果:随访10～138个月,平均74.8月,11例病人均存活,仅1例首程用γ刀治疗者43个月后局部复发,但被全脑照射+局部补量照射挽救。结论:局灶性颅内生殖细胞瘤单独全脑照射+局部补量放射治疗可获得很好的局部控制率和生存率。

Long-term results of radiotherapy for intracranial germinomas

Objective: To evaluate the long-term results of radiation therapy alone in patients with intracranial germinomas. Methods: Eleven patients received radiotherapy for diagnosed intracranial germinomas. Histologic confirmations of germ cell tumor were obtained in 5 of 11 cases, including 3 germinomas and 2 nongerminomatous germ cell tumors. The remaining 6 patients were presumed to have intracranial germ cell tumors based on clinical presentation, neuroradiographic imaging that suggested the presence of tumor in the pineal or suprasellar region and they had a classical radiodiagnostic trial of 20 Gy in an effort to confirm the presence of a radiation-responsive intracranial germ cell tumor. The median age at diagnosis was 16.8 years (range, 10~32). All patients received whole brain radiation or craniospinal irradiation followed by a boost to the primary site. The median dose of primary site was 52.2Gy (range,50~60). None of the patients received chemotherapy. Results: All patients are alive with a median follow-up of 74.8 months (range, 10~138). Only one patient relapsed 43 months after treatment of γ knife, but was subsequently salvaged with whole brain radiation followed by a boost to the primary site. Conclusion: This study confirms that treatment of localized intracranial germinomas with whole brain radiation alone followed by primary tumor boost has yielded a high rate of disease control and overall survivals.