Shibamoto Y, Sasai K, Kokubo M, Hiraoka M
Department of Oncology, Institute for Frontier Medical Sciences, Kyoto University, Japan.
J Neurooncol. 1999 Sep;44(2):181-5. doi: 10.1023/a:1006367316168.
Systemic chemotherapy has been increasingly used in the primary treatment of intracranial germinoma. However, the recurrence rate seems to be very high after treatment with chemotherapy alone. We used radiation to treat 5 patients harboring intracranial germinoma that recurred following primary chemotherapy. They had received systemic chemotherapy (4 with cisplatin plus etoposide and 1 with adriamycin, vincristine, cyclophosphamide, prednisolone, and cisplatin) 7-24 months before referral. All patients were treated with conventional radiotherapy directed to the primary tumor site or the craniospinal axis with a dose to the primary site ranging from 39.6 to 47.0 Gy (mean, 42.6 Gy). Response to radiation of all the recurrent tumors was good and all tumors disappeared on diagnostic imaging below the dose of 24 Gy. All patients are alive without further recurrence at 61-129 months after salvage radiotherapy. Germinomas recurring after primary chemotherapy do not seem to have acquired cross resistance to radiotherapy. They can usually be cured by standard radiation therapy with 40-47 Gy.
全身化疗已越来越多地用于颅内生殖细胞瘤的初始治疗。然而，单纯化疗后的复发率似乎非常高。我们采用放疗治疗了5例原发性化疗后复发的颅内生殖细胞瘤患者。他们在转诊前7至24个月接受了全身化疗（4例使用顺铂加依托泊苷，1例使用阿霉素、长春新碱、环磷酰胺、泼尼松龙和顺铂）。所有患者均接受针对原发肿瘤部位或全脑脊髓轴的常规放疗，原发部位的剂量范围为39.6至47.0 Gy（平均42.6 Gy）。所有复发性肿瘤对放疗的反应良好，在剂量低于24 Gy时，所有肿瘤在诊断影像上均消失。所有患者在挽救性放疗后61至129个月均存活且无进一步复发。原发性化疗后复发的生殖细胞瘤似乎并未对放疗产生交叉耐药性。它们通常可通过40至47 Gy的标准放疗治愈。
