Department of Neurosurgery, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.
Seoul National University College of Medicine, Seoul, South Korea.
BMC Cancer. 2018 Nov 16;18(1):1119. doi: 10.1186/s12885-018-5073-3.
Intracranial germinomas are one of the most radiosensitive tumors and are curable by radiotherapy (RT) alone. RT-only therapy without chemotherapy is effective. But, as patients with germinoma can expect long-term survival, the adverse effects of RT and late sequelae in survivors are of most concern. So, recently, standard treatment protocol of combination with chemotherapy and reduced dose of RT could be widely acceptable.
We report a patient with germinoma who developed RT-induced glioblastoma. He was diagnosed as biopsy-proven germinoma at the age of 12. Postoperatively, he underwent RT alone without chemotherapy and remained free of tumor without recurrence during long-term follow up. However, after almost 20 year, he developed RT-induced glioblastoma.
Although RT has the highest priority among treatments on intracranial germinomas, RT-only therapy with full dose for germinoma can have delayed severe complications. So, chemotherapy prior to reduced dose RT is more desirable.
颅内生殖细胞瘤是对放疗最敏感的肿瘤之一，单独放疗即可治愈。单纯放疗而不化疗是有效的。但是，由于生殖细胞瘤患者可以预期长期生存，因此人们最关注放疗的不良反应和幸存者的晚期后遗症。因此，最近，化疗联合低剂量放疗的标准治疗方案可能被广泛接受。
我们报告了一例生殖细胞瘤患者，他发生了放疗诱导的胶质母细胞瘤。他在 12 岁时被诊断为经活检证实的生殖细胞瘤。手术后，他仅接受了放疗，未进行化疗，在长期随访中肿瘤未复发，情况良好。然而，在近 20 年后，他患上了放疗诱导的胶质母细胞瘤。
虽然放疗在颅内生殖细胞瘤的治疗中具有最高的优先级，但对生殖细胞瘤进行全剂量的单纯放疗可能会导致延迟出现严重的并发症。因此，在进行低剂量放疗之前进行化疗更为理想。
