Department of Radiation Oncology, Institut Claudius Regaud / Institut Universitaire du Cancer de Toulouse - Oncopole, 1 avenue Irène Joliot-Curie, 31000, Toulouse, France.
Department of Medical Oncology, Centre Léon-Bérard, 28 rue Laennec, 69008, Lyon, France.
Crit Rev Oncol Hematol. 2020 Jun;150:102946. doi: 10.1016/j.critrevonc.2020.102946. Epub 2020 Apr 16.
The presence of brain metastases (BMs) from germ cell tumor (GCT) remains a rare situation. BMs predominantly occur among patients with testis primary tumor site, and are almost exclusively associated with non-seminomatous (NS) histologies. Two situations must be distinguished, which differ in terms of clinical presentation, overall prognostic and management. At diagnosis, BMs are almost systematically associated with extra-cerebral metastases and the cornerstone of treatment is chemotherapy, while the role of local treatment remains controversial. In the metachronous setting, BMs more frequently constitute an isolated site of relapse, the outcome is poorer, and the role of local treatment is more consensual. However, all these data widely come from old reports, with outdated radiation techniques. The recent advances in radiation oncology, especially the rising use of stereotactic radiotherapy, could lead to the reconsideration of ancient dogmas regarding the "radiosensitivity" of (NS)GCT and the role of radiotherapy among patients with BMs.
脑转移（BMs）来自生殖细胞瘤（GCT）仍然是一种罕见的情况。BMs 主要发生在睾丸原发性肿瘤患者中，几乎仅与非精原细胞瘤（NS）组织学相关。必须区分两种情况，它们在临床表现、总体预后和治疗方面存在差异。在诊断时，BMs 几乎总是与脑外转移相关，治疗的基石是化疗，而局部治疗的作用仍存在争议。在异时性情况下，BMs 更常构成孤立的复发部位，预后较差，局部治疗的作用更为一致。然而，所有这些数据主要来自旧报告，采用的是过时的放射技术。放射肿瘤学的最新进展，特别是立体定向放射治疗的使用增加，可能会重新考虑关于（NS）GCT 的“放射敏感性”和 BM 患者放疗作用的古老定论。
