@article{e95b3673c4f64bf580b19a2923233dbf,
title = "Outcomes of intracranial germinoma - A retrospective multinational Asian study on effect of clinical presentation and differential treatment strategies",
abstract = "Background: This multinational study was conducted to report clinical presentations and treatment strategies in patients with intracranial germinomas across selected Asian centers, including failure patterns, risk factors, and outcomes. Methods: A retrospective data collection and analysis of these patients, treated between 1995 and 2015 from eight healthcare institutions across four countries was undertaken. Results: From the results, 418 patients were analyzed, with a median follow-up of 8.9 years; 79.9\% of the patients were M0, and 87.6\% had β-human chorionic gonadotropin values <50 mIU/mL. The 5/10-year overall survival (OS) and recurrence-free survival (RFS) rates were 97.2\%/96.2\% and 89.9\%/86.9\%, respectively. RFS was predicted by the radiotherapy (RT) field, with focal RT having the worst outcome, whereas chemotherapy usage had no impact on survival. Among patients who received chemotherapy, response to chemotherapy did not predict survival outcomes. In M0 patients, primary basal ganglia tumors predicted a worse RFS. In patients with bifocal tumors, an extended field RT was associated with better outcomes. In multivariable analysis, only RT fields were associated with RFS. In relapsed patients, salvage rates were high at 85.7\%. Additionally, patients who received salvage RT had a better outcome (91.6\% vs. 66.7\%). Conclusions: Survival outcomes of patients with germinoma were excellent. Thus, the focus of treatment for intracranial germinoma should be on survivorship. Further studies are warranted to find the optimal intensity and volume of radiation, including the role of chemotherapy in the survival of patients with intracranial germinomas, considering age, primary tumor location, and extent of disease.",
keywords = "chemotherapy, intracranial germinoma, outcomes, radiotherapy, treatment",
author = "Koh, \{Kyung Nam\} and Wong, \{Ru Xin\} and Lee, \{Dong Eun\} and Han, \{Jung Woo\} and Byun, \{Hwa Kyung\} and Yoon, \{Hong In\} and Kim, \{Dong Seok\} and Lyu, \{Chuhl Joo\} and Kang, \{Hyoung Jin\} and Hong, \{Kyung Taek\} and Lee, \{Joo Ho\} and Kim, \{Il Han\} and Phi, \{Ji Hoon\} and Kim, \{Seung Ki\} and Wong, \{Tai Tong\} and Lee, \{Hsin Lun\} and Lai, \{I. Chun\} and Kang, \{Yu Mei\} and Ra, \{Young Shin\} and Ahn, \{Seung Do\} and Im, \{Ho Joon\} and Looi, \{Wen Shen\} and Low, \{Sharon Yin Yee\} and Tan, \{Enrica Ee Kar\} and Park, \{Hyun Jin\} and Shin, \{Sang Hoon\} and Hiroshi Fuji and Suh, \{Chang Ok\} and Chen, \{Yi Wei\} and Kim, \{Joo Young\}",
note = "Publisher Copyright: {\textcopyright} 2021 The Author(s). Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved.",
year = "2022",
month = aug,
day = "1",
doi = "10.1093/neuonc/noab295",
language = "English",
volume = "24",
pages = "1389--1399",
journal = "Neuro-Oncology",
issn = "1522-8517",
publisher = "Oxford University Press",
number = "8",
}