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Treatment outcome and long-term follow-up of central nervous system germ cell tumor using upfront chemotherapy with subsequent photon or proton radiation therapy: a single tertiary center experience of 127 patients
DC Field | Value | Language |
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dc.contributor.author | Hong, Kyung Taek | - |
dc.contributor.author | Lee, Da Hye | - |
dc.contributor.author | Kim, Bo Kyung | - |
dc.contributor.author | An, Hong Yul | - |
dc.contributor.author | Choi, Jung Yoon | - |
dc.contributor.author | Phi, Ji Hoon | - |
dc.contributor.author | Cheon, Jung-Eun | - |
dc.contributor.author | Kang, Hyoung Jin | - |
dc.contributor.author | Kim, Seung-Ki | - |
dc.contributor.author | Kim, Joo-Young | - |
dc.contributor.author | Park, Sung-Hye | - |
dc.contributor.author | Kim, Il Han | - |
dc.contributor.author | Shin, Hee Young | - |
dc.date.accessioned | 2020-12-31T01:44:48Z | - |
dc.date.available | 2020-12-31T10:54:09Z | - |
dc.date.issued | 2020-10-09 | - |
dc.identifier.citation | BMC Cancer. 2020 Oct 09;20(1):979 | ko_KR |
dc.identifier.issn | 1471-2407 | - |
dc.identifier.uri | https://hdl.handle.net/10371/171572 | - |
dc.description.abstract | Background
Central nervous system germ cell tumors (CNS GCTs) are a heterogeneous group of brain tumors, which are more common in Asian countries. There have been different therapeutic strategies in treating germinoma and non-germinomatous germ cell tumors (NGGCT), depending on prognosis. Moreover, long-term follow up should be emphasized due to higher late complication rates. Here, we investigated long-term outcomes and complication profiles of 127 CNS GCT patients who received uniform upfront chemotherapy. Methods We retrospectively evaluated outcomes of CNS GCT patients treated in Seoul National University Childrens Hospital from August 2004 to April 2019. Patients were classified as low risk (LR) or high risk (HR) based on pathologic diagnosis and tumor markers. Most patients received upfront systemic chemotherapy with carboplatin, cyclophosphamide, etoposide, and/or bleomycin, followed by either proton or photon radiation therapy according to patients choice. Results The median age at diagnosis was 11.9 (range, 3.8–25.1) years, and 54.3% of patients were LR. Photon and proton radiation therapy were administered to 73.2 and 25.2% of patients, respectively. In both LR and HR groups, there were no significant differences in survival between photon and proton radiation therapy. The 10-year relapse incidences were 9.3 and 5.6% in the LR and HR groups, respectively. All recurrences, except one, were local relapse. Six secondary malignancies occurred; the 10-year incidences of secondary malignancy were 2.2 and 7.6% in the LR and HR groups, respectively. The 10-year overall survival rates were 98.3 ± 1.7 and 91.8 ± 3.9% in the LR and HR groups, respectively. In a subgroup analysis of HR group, pathologically diagnosed NGGCT patients (n = 20) showed worse 10-year EFS (65.9 ± 11.9%, p < 0.001) and OS (77.9 ± 9.8%, p = 0.024) rates compared to other HR patients who were not pathologically diagnosed or were confirmed as germinoma with elevated tumor markers. All mortalities were related to disease progression or secondary malignancy. Conclusion The strategy of treating CNS GCTs with upfront chemotherapy according to risk groups resulted in good clinical outcomes and acceptable relapse incidence. However, further modification in the definition of the HR group is needed to reduce long-term complications. | ko_KR |
dc.description.sponsorship | This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI18C0998). | ko_KR |
dc.language.iso | en | ko_KR |
dc.publisher | BMC | ko_KR |
dc.title | Treatment outcome and long-term follow-up of central nervous system germ cell tumor using upfront chemotherapy with subsequent photon or proton radiation therapy: a single tertiary center experience of 127 patients | ko_KR |
dc.type | Article | ko_KR |
dc.contributor.AlternativeAuthor | 홍경택 | - |
dc.contributor.AlternativeAuthor | 이다혜 | - |
dc.contributor.AlternativeAuthor | 김보경 | - |
dc.contributor.AlternativeAuthor | 안홍율 | - |
dc.contributor.AlternativeAuthor | 최정윤 | - |
dc.contributor.AlternativeAuthor | 피지훈 | - |
dc.contributor.AlternativeAuthor | 전정은 | - |
dc.contributor.AlternativeAuthor | 강형진 | - |
dc.contributor.AlternativeAuthor | 김승기 | - |
dc.contributor.AlternativeAuthor | 김주영 | - |
dc.contributor.AlternativeAuthor | 박성혜 | - |
dc.contributor.AlternativeAuthor | 김일한 | - |
dc.contributor.AlternativeAuthor | 신희영 | - |
dc.identifier.doi | 10.1186/s12885-020-07484-y | - |
dc.citation.journaltitle | BMC Cancer | ko_KR |
dc.language.rfc3066 | en | - |
dc.rights.holder | The Author(s) | - |
dc.date.updated | 2020-10-11T03:23:51Z | - |
dc.citation.number | 1 | ko_KR |
dc.citation.startpage | 979 | ko_KR |
dc.citation.volume | 20 | ko_KR |
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