The Analysis of Outcomes of Intracranial Germ Cell Tumors: A Single-institute Study

Purpose: For analyzing the epidemiology and treatment according to the KSPNO protocol results of germ cell tumor patients at our institution.Methods: From 2004 to 2019, of 6494 patients with intracranial neoplasms, 61 (0.9%) patients with iGCTs were enrolled. Pediatric patients underwent chemotherapy and radiotherapy according to the Korean Society for Pediatric Neuro-Oncology (KSPNO) protocol, and adult patients were treated with bleomycin, etoposide, and cisplatin (BEP) regimens. Survival rates, recurrence rates, and posttreatment morbidity were analyzed to identify risk factors. Results: The median age was 20.0 years (range: 1-42), and the follow-up duration was 77.7 months (range: 10.0-203.4 months). The tumors developed most frequently in the pineal gland (49.2%). There were no significant differences in outcomes between protocols, but the KSPNO protocol group had lower tumor recurrence (14.8% vs. 17.6%, p=0.524) and mortality rates (0% vs. 5.9%, p=0.307) than the other groups. According to the pathological subtype, the outcomes were significantly different between the germinoma and nongerminomatous germ cell tumor (NGGCT) groups. The 10-year progression-free survival rates were 93.2% and 67.1% in the germinoma and NGGCT groups, respectively (p = 0.009). The NGGCT pathological type (p=0.021) was a significant recurrence-associated factor in the multivariate analysis. Significant adverse occurred in 14 patients (7 patients in each group).Conclusions: Pure germinomas have a higher survival and lower recurrence rate than NGGCTs. A multidisciplinary approach is needed to select appropriate iGCT treatments, and reducing the radiation dose could minimize posttreatment morbidity.Clinical trial registrationNot applicable