Proton Beam Therapy for Intracranial Germ Cell Tumors in Pediatric, Adolescent, and Young Adult Patients: A Single-Center Experience.
L’essentiel
Radiotherapy is essential for the treatment of intracranial germ cell tumor (ICGCT), but late effects are a concern. Proton beam therapy (PBT) is a promising modality as it reduces the radiotherapy dosage needed for the normal brain. Herein, we report the long-term outcomes for one of the largest samples of pediatric/adolescent and young adult patients with ICGCT treated with PBT at our institution. We retrospectively analyzed patients aged <30 years who received PBT for ICGCT at our institution. Overall survival (OS) and progression-free survival (PFS) were estimated, and adverse events (AEs) were graded. Thirty-six patients were enrolled: 23 with pure germinoma (PG) and 13 with non-germinomatous germ cell tumor (NGGCT). Most patients received upfront chemotherapy. The median prescribed doses were 25.2 Gy (relative biological effectiveness [RBE]) for PG and 48.6 Gy (RBE) for NGGCT. The median follow-up duration was 58 months. The 5-year OS rates were 91% and 88% for PG and NGGCT, respectively, with corresponding 5-year PFS rates of 94% and 90%. Two patients experienced locoregional relapse. Grade ≥2 late AEs included seizure, hearing impairment, and newly diagnosed learning disability. Nearly all patients, excluding the one with learning disability, attended regular classes after PBT. All 12 high-school graduates at the time of the analysis pursued higher education or employment. PBT for ICGCT yielded a survival rate comparable with that documented in previous reports, with favorable safety profiles.
Synthèse détaillée
Résumé original
Radiotherapy is essential for the treatment of intracranial germ cell tumor (ICGCT), but late effects are a concern. Proton beam therapy (PBT) is a promising modality as it reduces the radiotherapy dosage needed for the normal brain. Herein, we report the long-term outcomes for one of the largest samples of pediatric/adolescent and young adult patients with ICGCT treated with PBT at our institution. We retrospectively analyzed patients aged <30 years who received PBT for ICGCT at our institution. Overall survival (OS) and progression-free survival (PFS) were estimated, and adverse events (AEs) were graded. Thirty-six patients were enrolled: 23 with pure germinoma (PG) and 13 with non-germinomatous germ cell tumor (NGGCT). Most patients received upfront chemotherapy. The median prescribed doses were 25.2 Gy (relative biological effectiveness [RBE]) for PG and 48.6 Gy (RBE) for NGGCT. The median follow-up duration was 58 months. The 5-year OS rates were 91% and 88% for PG and NGGCT, respectively, with corresponding 5-year PFS rates of 94% and 90%. Two patients experienced locoregional relapse. Grade ≥2 late AEs included seizure, hearing impairment, and newly diagnosed learning disability. Nearly all patients, excluding the one with learning disability, attended regular classes after PBT. All 12 high-school graduates at the time of the analysis pursued higher education or employment. PBT for ICGCT yielded a survival rate comparable with that documented in previous reports, with favorable safety profiles.