Nguyen Quynh-Nhu, Chang Eric L, Allen Pamela K, Maor Moshe H, Ater Joann L, Mahajan Anita, Wolff Johannes E A, Weinberg Jeffrey S, Woo Shiao Y
Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
Cancer. 2006 Nov 1;107(9):2228-36. doi: 10.1002/cncr.22246.
The authors compared the patterns of failure in patients with intracranial germinoma who were managed with either chemotherapy and focal irradiation or with craniospinal irradiation (CSI).
A retrospective review was conducted on 21 patients with intracranial germinoma and treated with radiotherapy (RT) to the central nervous system at The University of Texas M. D. Anderson Cancer Center from 1981 to 2002. The study group was comprised of 13 males and 8 females with a median age at diagnosis of 19 years. Nine patients received chemotherapy prior to focal RT. Twelve patients received CSI.
The actuarial 10-year survival rate for all patients was 86%. The overall survival rate at 10 years was 89% for patients who received focal RT and 83% for patients who received CSI (P = .73). The 10-year local control rate in the brain for patients who received focal irradiation was 59% compared with 100% for patients who received CSI (P = .08). The rate of distant control in the spine at 5 years was 62% for patients who received focal irradiation and 100% for patients who received CSI (P = .04).
Although focal techniques of irradiation with chemotherapy are attractive methods that limited the volume irradiated, the strategy appeared to be associated with increased rates of failures in the brain and spine.
作者比较了接受化疗和局部放疗或全脑全脊髓放疗（CSI）的颅内生殖细胞瘤患者的失败模式。
对1981年至2002年在德克萨斯大学MD安德森癌症中心接受中枢神经系统放射治疗（RT）的21例颅内生殖细胞瘤患者进行回顾性研究。研究组包括13名男性和8名女性，诊断时的中位年龄为19岁。9例患者在局部放疗前接受了化疗。12例患者接受了全脑全脊髓放疗。
所有患者的10年精算生存率为86%。接受局部放疗的患者10年总生存率为89%，接受全脑全脊髓放疗的患者为83%（P = 0.73）。接受局部放疗的患者脑部10年局部控制率为59%，而接受全脑全脊髓放疗的患者为100%（P = 0.08）。接受局部放疗的患者5年脊柱远处控制率为62%，接受全脑全脊髓放疗的患者为100%（P = 0.04）。
尽管化疗联合局部放疗技术是限制照射体积的有吸引力的方法，但该策略似乎与脑和脊柱失败率增加有关。
