Treatment Outcomes and Prognostic Factors of Intracranial Germ Cell Tumors: A Single Institution Retrospective Study.

BACKGROUND

This study analyzed the epidemiology and treatment outcomes of germ cell tumor patients at a single institution.

METHODS

A retrospective analysis was conducted on intracranial germ cell tumor (iGCT) patients treated at a single tertiary hospital from 2004 to 2019. Patients were categorized based on treatment modality: Korean Society for Pediatric Neuro-Oncology (KSPNO) protocol or bleomycin, etoposide, and cisplatin with radiation therapy.

RESULTS

Forty-nine iGCT patients treated with combined chemotherapy and radiotherapy were analyzed. The median age was 19 years (range: 6-40), with a median follow-up duration of 148.0 months (range: 10.5-265.5). Tumors were most common in the pineal gland (51.0%). Although no significant differences in outcomes were observed between treatment modalities, outcomes varied significantly by pathological type. The 10-year progression-free survival rates for germinoma and non-germinomatous germ cell tumors (NGGCTs) were 88.1% and 32.7%, respectively (p=0.003), while the 10-year overall survival rates were 92.9% and 67.5%, respectively (p<0.001). Fourteen patients experienced CTCAE (Common Terminology Criteria for Adverse Events) grade ≥3 adverse events, with one event-related death.

CONCLUSION

Pure germinoma demonstrated higher survival and lower recurrence rates compared to NGGCT. The KSPNO protocol appears to be an acceptable and safe treatment option for iGCT patients. Further multi-institutional studies with larger cohorts are warranted.