Skip to main content
SpringerLink
Log in

Intracranial germ-cell tumours — treatment results and residuals

  • Neuropediatrics
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

There is only sparse information about the development of children after successful treatment for intracranial germ-cell tumours. Between January 1981 and June 1992, 26 children with intracranial germ-cell tumours were treated in the University Hospital Hamburg-Eppendorf. We report on treatment results, long standing residuals and the “quality of life” of these patients. The long-term event-free survival was 88% for the germinomas and 43% for the malignant teratomas. Of the patients 58% had no relevant functional neurological deficits and 37% had mild impairment. Only 1 patient with metastatic disease was severely handicapped. Six patients showed neuro-endocrine dysfunction. All of them had suprasellar/hypothalamic lesions and all received successful substitution therapy. As to neuropsychological functions, 53% of the patients had no or only mild disturbances. The most affected function was speed of information processing. Of the children 69% were able to proceed with their education at the same level as before therapy. The overall self-assessment revealed good results in 75% of the patients.

Conclusion

After surgical removal and radiation therapy long-term survival of intracranial germinomas amounts to 88%. Despite craniospinal axis radiation severe residuals are rare and a good quality of life is common. In malignant teratomas treatment regimens including chemotherapy are much less successful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ADH :

antidiuretic hormone

EPS :

event free survival

References

  1. Allen JC (1991) Controversies in the management of intracranial germ-cell tumors. Neurol Clin 9(2):441–452

    PubMed  Google Scholar 

  2. Allen JC, Kim JH, Packer RJ (1987) Neoadjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system. J Neurosurg 67:65–70

    PubMed  Google Scholar 

  3. Baumgartner JE, Edwards MS (1992) Pineal tumors. Neurosurg Clin North Am 3(4):853–862

    Google Scholar 

  4. Bruce JN, Stein BM (1990) Pineal tumours. Neurosurg Clin North Am 1:123–138

    Google Scholar 

  5. Czirjak S, Vajda J, Pasztor E (1992) Management of pineal region tumors. Neurol Res 14:241–247

    PubMed  Google Scholar 

  6. D'Andrea AD, Packer RJ, Rorke LB, Bilaniuk LT, Sutton LN, Bruce DA, Schut L (1987) Pineocytomas of childhood. A reappraisal of natural history and response to therapy. Cancer 59:1353–1357

    PubMed  Google Scholar 

  7. Dearnaley DP, A'Hern RP, Whittaker S, Bloom HJG (1990) Pineal and CNS germ-cell tumors: Royal Marsden Hospital experience 1962–1987. Int J Radiat Oncol Biol Phys 18:773–781

    PubMed  Google Scholar 

  8. Dempsey PK, Lunsford LD (1992) Stereotactic radiosurgery for pineal region tumors. Neurosurg Clin North Am 3(1):245–253

    Google Scholar 

  9. Duffner PK, Cohen ME, Thomas P (1983) Late effects of treatment on the intelligence of children with posterior fossa tumors. Cancer 51:233–237

    PubMed  Google Scholar 

  10. Edwards MSB, Hudgins RJ, Wilson CB, Levin VA, Wara WM (1988) Pineal region tumors in children. J Neurosurg 68:689–697

    PubMed  Google Scholar 

  11. Farwell JR, Flannery JT (1989) Pinealomas and germinomas in children. J Neuro-Oncol 7(1):13–19

    Google Scholar 

  12. Felix I, Becker LE (1990–91) Intracranial germ-cell tumors in children: an immuno histochemical and electron microscopic study. Pediatr Neurosurg 16(3):156–162

    Google Scholar 

  13. Glauser TA, Packer RJ (1991) Cognitive deficits in long-term survivors of childhood brain tumors. Childs Nerv Sys 7:2–12

    Google Scholar 

  14. Goebel U, Bamberg M, Budach V, Haas RJ, Janka Schaub G, Kühl J, Lenard HG, Rister M, Spaar HJ (1989) Intracraniale Keimzelltumoren: Analyse der Therapiestudie MAKEI 83/86 und Protokolländerungen für die Nachfolgestudie. Klin Pädiatr 201:261–268

    Google Scholar 

  15. Herrmann HD, Westphal M, Schulte FJ, Winkler K, Laas R (1994) Treatment of nongerminomatous germ-cell tumors of the pineal region. Neurosurgery 34(3):524–529

    PubMed  Google Scholar 

  16. Herrmann HD, Winkler D, Westphal M (1992) Treatment of tumors of the pineal region and posterior part of the third ventricle. Acta Neurochirurgica 116:137–146

    PubMed  Google Scholar 

  17. Hirsch JF, Renier D, Czemichow R, Benveniste L, Pierre-Kahn A (1979) Medulloblastoma in childhood: survival and functional results. Acta Neurochir 48:1–15

    Google Scholar 

  18. Ho DM, Liu HC (1992) Primary intracranial germ-cell tumor. Pathologic Study of 51 patients. Cancer 70:1577–1584

    PubMed  Google Scholar 

  19. Inoue HK, Naganuma H, Ono N (1987) Pathology of intracranial germ-cell tumors: immunochemical, immunohistochemical and electron microscopic investigations. Oncology 5(2):105–115

    Google Scholar 

  20. Jenkin D, Berry M, Chan H, Greenberg M, Hendrick B, Hoffmann H, Humphreys R, Sonley M, Weitzman S (1990) Pineal region germinomas in childhood. Treatment considerations. Int J Radiat Oncol Biol Phys 18:541–545

    PubMed  Google Scholar 

  21. Jennings MT, Gelman R, Hochberg F (1985) Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg 63:155–167

    PubMed  Google Scholar 

  22. Kalff R, Clar HE, Bamberg M, Holldack J (1985) Tumors of the pineal region in children and adolescents. Acta Neurochir [Supple] 35:119–122

    Google Scholar 

  23. LeBaron S, Zeltzer PM, Zeltzer LK, Scott SE, Marlin AE (1988) Assessment of quality of survival in children with medulloblastoma and cerebellar astrocytoma. Cancer 62:1215–1222

    PubMed  Google Scholar 

  24. Ledigo A, Packer RJ, Sutton LN, D'Angio G, Rorke LB, Bruce DA, Schut L (1989) Suprasellar germinomas in childhood. Cancer 63:340–344

    PubMed  Google Scholar 

  25. Nakagawa K, Aoki Y, Akanuma A, Sakata K, Karasawa K, Terahara A, Onogi Y, Hasezawa K, Muta N, Sasaki Y (1992) Radiation therapy of intracranial germ-cell tumors with radiosensitivity assessment. Radiat Oncol 10(2):55–61

    Google Scholar 

  26. Packer RJ, Sutton LN, Atkins TE, et al (1989) A prospective study of cognitive function in children receiving whole-brain radiotherapy and chemotherapy: 2-year results. J Neurosurg 70:707–713

    PubMed  Google Scholar 

  27. Raimondi AJ, Tomita T (1979) Medulloblastoma in childhood: Comparative results of partial and total resection. Childs Brain 5:310–328

    PubMed  Google Scholar 

  28. Sakai N, Yamada H, Andoh T, Hirata T, Shimizu K, Shinoda J (1988) Primary intracranial germ-cell tumors. Retrospective analysis with special reference to long-term results of treatment and the behavior of rare types of tumors. Acta Oncol 27:43–50

    PubMed  Google Scholar 

  29. Sano K, Matsutani M, Sero T (1989) So-called intracranial germ-cell tumors: personal experiences and a theory of their pathogenesis. Neurol Res 11(2):118–126

    PubMed  Google Scholar 

  30. Schulte FJ, Herrmann Hd, Müller D, Franke H, Saeger W, Spaar FW, Bartels S (1987) Pineal region tumours of childhood. E J Pediatr 146(3):233–245

    Google Scholar 

  31. Schulte FJ, Matthes-Martin S, Zarbock G, Herrmann HD (1987) Prognose and Lebensqualität nach Pinealis-Logen-Tumoren im Kindesalter. Klin Pädiatr 199:429–439

    Google Scholar 

  32. Silverman CL, Palkes H, Talent B, Kovnar E, Clouse JW, Thomas PRM (1984) Late effects of radiotherapy on patients with cerebellar medulloblastoma. Cancer 54:825–829

    PubMed  Google Scholar 

  33. Vaquero J, Ramiro J, Martinez R, Bravo G (1992) Neurosurgical experience with tumors of the pineal region at Clinica Puerto de Hierro. Acta Neurochir 116:23–32

    Google Scholar 

  34. Zarbock G, Matthes-Martin S, Schulte FJ (1989) Lebensqualität und Restschadenssymptomatik bei Kleinhirntumoren im Kindes-und Jugendalter. Klin Pädiatr 201:337–345

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Departments of Paediatrics and of Neurosurgery, University Hospital Hamburg-Eppendorf, D-20251, Hamburg, Germany

    C. Haupt, U. Ancker, M. Müller, H. D. Herrmann & F. J. Schulte

Authors
  1. C. Haupt
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Ancker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. H. D. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F. J. Schulte
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haupt, C., Ancker, U., Müller, M. et al. Intracranial germ-cell tumours — treatment results and residuals. Eur J Pediatr 155, 230–236 (1996). https://doi.org/10.1007/BF01953944

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01953944

Key words

Search

Navigation