Zhou Zhirui, Liu Jiabing, Yue Qi, Chen Lingxiao, Zhang Xiwei, Lin Xin, Zheng Lin, Wang Enmin, Wang Yang, Mao Ying
Radiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
National Center for Neurological Disorders, Shanghai, 200052, China.
BMC Cancer. 2025 Jan 7;25(1):26. doi: 10.1186/s12885-024-13323-1.
To determine the optimal treatment modality for intracranial germinoma (IG).
A search of Medline, Embase, Web of Science and Cochrane Library was conducted up to April, 2024. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup analysis was applied according to radiotherapy (RT) alone or with chemotherapy (CTx).
Total 37 studies were included in systematic review. Most IG patients were treated with biopsy or resection followed by RT with or without CTx. Prognosis of IG patients with different surgical resection is similar. Meta-analyses demonstrated focal field RT were with higher recurrence rate compared with craniospinal irradiation (CSI) [RR = 7.128, 95% CI (5.083, 9.995)], whole-brain RT (WBRT) [RR = 4.094, 95% CI (2.923, 5.735)] or whole-ventricle RT (WVRT) [RR = 3.361, 95% CI (2.126, 5.312)]; both WBRT and WVRT were also with higher recurrence compared with CSI; but no significant difference in recurrence and mortality between WVRT and WBRT. Total 24 studies reported treatment-related acute and/or late toxicity, combination CTx increased acute toxic, and expanded RT field and/or dose increased late toxicity.
Based on our findings, focal field RT is not recommended regardless of whether combined with CTx for intracranial pure germinoma. Although CSI is associated with better local control than other reduced-field RT, considering the potential toxicity and pattern of relapse, whole ventricles irradiation is more reasonable for localized or nonmetastatic germinoma. Reduced-dose CSI with or without chemotherapy is effective in metastatic or disseminated IG.
确定颅内生殖细胞瘤（IG）的最佳治疗方式。
截至2024年4月，检索了Medline、Embase、科学引文索引和考科蓝图书馆。计算合并风险比（RR）和95%置信区间（CI）。根据单纯放疗（RT）或联合化疗（CTx）进行亚组分析。
系统评价共纳入37项研究。大多数IG患者接受活检或切除，随后进行有或无CTx的RT。不同手术切除的IG患者预后相似。荟萃分析表明，与全脑脊髓照射（CSI）[RR = 7.
