| Responses and Toxicities of Risk-adapted Chemotherapy in Pediatric Intracranial Germ Cell Tumors |
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Dong Kil You1, Soo Hyun Lee1, Keon Hee Yoo1, Ki Woong Sung1, Do Hoon Lim2, Hyung Jin Shin3, Hong Hoe Koo1 |
1Department of Pediatrics, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
2Department of Radiation Oncology, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
3Department of Neurosurgery, Samsung Seoul Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea |
| 소아 두개 내 생식 세포종에서 위험군에 따른 화학요법의 치료 반응 및 독성 |
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유동길1, 이수현1, 유건희1, 성기웅1, 임도훈2, 신형진3, 구홍희1 |
1성균관대학교 의과대학 삼성서울병원 소아과
2성균관대학교 의과대학 삼성서울병원 방사선종양학교실
3성균관대학교 의과대학 삼성서울병원 신경외과학교실 |
Correspondence:
Hong Hoe Koo, Email: hhkoo@smc.samsung.co.kr
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| 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. |
| Key Words:
Intracranial germ cell tumor , Chemotherapy , Responses , Toxicities |
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