Nakagawa K, Aoki Y, Akanuma A, Sakata K, Karasawa K, Terahara A, Onogi Y, Hasezawa K, Muta N, Sasaki Y
Department of Radiology, Faculty of Medicine, University of Tokyo, Japan.
Radiat Med. 1992 Mar-Apr;10(2):55-61.
Fifty patients with pineal and/or suprasellar tumors were treated in the Department of Radiology, University of Tokyo, from 1975 to 1988. Histological diagnosis was obtained in 28 cases, whereas 22 patients were irradiated without pathological verification. Of the 28 patients with histological diagnosis, 11 had germinomas, 13 non-germinoma germ cell tumors, including nine teratomas, two choriocarcinomas and two embryonal carcinomas, two pineocytomas and two pineoblastomas. The treatment protocol since 1981 has been that, after 20 Gy is given with a local irradiation field, if tumor regression is marked and germinoma is highly suspected, whole brain or whole CNS irradiation is performed subsequently; otherwise, surgical intervention is performed followed by systemic chemotherapy plus radiation therapy. The five-year survival rates of histologically proven germinomas, histologically proven non-germinoma germ cell tumors, and clinically suspected germinomas by means of the above-mentioned method as well as tumor marker status were 73%, 28%, and 83%, respectively. The overall five-year survival rate was 61.3%. A statistically significant difference was found between the survival rates for the 11 cases with histologically proven germinoma and the 13 cases with non-germinoma germ cell tumors, although there was no significant difference between the survival rates for the histologically proven germinomas and the clinically suspected germinomas. Therefore radiation therapy is an effective treatment method for the management of intracranial germ cell tumors.
1975年至1988年期间，东京大学放射科对50例松果体和/或鞍上区肿瘤患者进行了治疗。28例获得了组织学诊断，而22例患者在未进行病理证实的情况下接受了放疗。在28例有组织学诊断的患者中，11例为生殖细胞瘤，13例为非生殖细胞性生殖细胞肿瘤，包括9例畸胎瘤、2例绒毛膜癌和2例胚胎癌，2例松果细胞瘤和2例松果体母细胞瘤。自1981年以来的治疗方案是，在局部照射野给予20 Gy后，如果肿瘤明显缩小且高度怀疑为生殖细胞瘤，则随后进行全脑或全中枢神经系统照射；否则，进行手术干预，随后进行全身化疗加放疗。经组织学证实的生殖细胞瘤、经组织学证实的非生殖细胞性生殖细胞肿瘤以及通过上述方法临床怀疑为生殖细胞瘤的五年生存率以及肿瘤标志物状态分别为73%、28%和83%。总体五年生存率为61.3%。经组织学证实的11例生殖细胞瘤患者与13例非生殖细胞性生殖细胞肿瘤患者的生存率之间存在统计学显著差异，尽管经组织学证实的生殖细胞瘤与临床怀疑的生殖细胞瘤的生存率之间没有显著差异。因此，放射治疗是颅内生殖细胞肿瘤治疗的一种有效方法。
