Skip to main content
SpringerLink
Log in
Book cover

Intracranial Germ Cell Tumors pp 243–281Cite as

Chemotherapy for CNS GCTs

  • Chapter

  • 140 Accesses

Abstract

The conventional therapy for CNS GCTs is irradiation [73], administered either alone (mainly for germinomas) or with chemotherapy (for non-germinomatous GCTs). Germinomas are exquisitely radiosensitive; 65% to 95% 5-year survival rates have been reported for patients with germinomas when the treatment is irradiation alone. Non-germinomatous GCTs are less sensitive to irradiation and the 5-year survival rates for patients afflicted with them range from 20% to 56% [58,82]. Notwithstanding its effectiveness, cranial irradiation may lead to long-term sequelae, including intellectual deterioration, not only in children [27], but also in adults [24]. It may also lead to growth retardation, endocrine dysfunction [22], hearing loss and about a 12% incidence of secondary tumors [52]. Craniospinal irradiation carries the additional morbidity of growth arrest, marrow suppression and damage to the gonadal organs. Reports of long term survivors of CNS GCTs treated with irradiation emphasize its long-term cognitive effects, including difficulties with school and social interactions.

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

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Allen JC, Bosl G, Walker R (1985) Chemotherapy trials in recurrent primary intracranial germ cell tumors. J Neuro-Oncol 3: 147–152

    Article  CAS  Google Scholar 

  2. Allen J (1987) Management of primary intracranial germ cell tumors of childhood. Pediatr Neurosci 13: 151–157

    Google Scholar 

  3. 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

    Article  PubMed  CAS  Google Scholar 

  4. Allen JC, Da Rosso RC, Donahue B et al (1994) A phase II trial of pre irradiation carboplatin in newly diagnosed germinoma of the central nervous system. Cancer 74: 940–944

    Article  PubMed  CAS  Google Scholar 

  5. Aprikian AG, Herr HW, Bajorin DF et al (1994) Resection of post chemotherapy residual masses and limited retroperitoneal lymphadenectomy in patients with metastatic testicular nonseminomatous germ cell tumors. Cancer 74: 1329–1334

    Article  PubMed  CAS  Google Scholar 

  6. Balmaceda C, Finaly J, Heller G et al (1994) Prognostic factors at diagnosis in patients with primary central nervous system germ cell tumors: a report of an international collaborative trial of chemotherapy. Prog Proceed ASCO 13: 176 (abstr)

    Google Scholar 

  7. Balmaceda C, Finlay J, Rosemblum M et al (1995) Tumor markers in the evaluation of central nervous system germ cell tumors at diagnosis. Neurology 45: 450 (abstr)

    Google Scholar 

  8. Balmaceda C, Heller G, Rosenbaum M et al (1996) Chemotherapy without irradiation — a novel approach for newly diagnosed central nervous system germ cell tumors: results of an international cooperative trial. J Clin Oncol 14: 2908–2915

    PubMed  CAS  Google Scholar 

  9. Balmaceda C, Merchant T, Heller G et al (1996) Retrieval of central nervous system germ cell tumors, treated with initial chemotherapy alone, following first relapse. Presented at the 7th International Symposium in Pediatric Neuro-Oncology, March 23, 1996

    Google Scholar 

  10. Baranzelli MC, Patte C, Bouffet E et al (1997) Nonmetastatic intracranial germinoma. The French Society of Pediatric Oncology experience. Cancer 80: 1792–1797

    Article  PubMed  CAS  Google Scholar 

  11. Baranzelli MC, Patte C, Bouffet E et al (1998) An attempt to treat pediatric intracranial AFP and BHCG secreting germ cell tumors with chemotherapy alone. SFOP experience with 18 cases. J Neuro Oncol 37: 229–239

    Article  CAS  Google Scholar 

  12. Beyer J, Kramar A, Mandans R et al (1996) High-dose chemotherapy as salvage treatment in germ cell tumors: a multivariate analysis of prognostic variables. J Clin Oncol 14: 2638–2645

    PubMed  CAS  Google Scholar 

  13. Biron P, Brunet-Mentigny M, Bayle J et al (1989) Cisplatin, VP-16 and ifosfamide and autologous bone marrow transplantation in poor prognosis non seminomatous germ cell tumors. Proc Am Soc Clim Oncol 8: 148

    Google Scholar 

  14. Bosl GJ, Geller NL, Cirrrincione C et al (1983) Multivariate analysis of prognostic variables in patients with metastic testicular cancer. Cancer Res 43: 3403–3407

    PubMed  CAS  Google Scholar 

  15. Bosl GJ, Yagoda A, Whitmore WF Jr et al (1984) VP-16 and cisplatin in the treatment of patients with refractory germ cell tumors. Am J Clin Oncol 7: 327–330

    Article  PubMed  CAS  Google Scholar 

  16. Calaminus G, Bamberg M, Baranzelli MC et al (1994) Intracranial germ cell tumors: a comprehensive update of the European data. Neuropediatrics 25: 26–32

    Article  PubMed  CAS  Google Scholar 

  17. Calaminus G, Bamberg M, Harms D et al (1995) Intracranial germ cell tumors (GCTs): results of the MAKEI 89 therapy protocol. Med Ped Oncology 23: 233 (abstr)

    Google Scholar 

  18. Calaminus G, Andreussi L, Garre ML et al (1997) Secreting germ cell tumors of the central nervous system (CNS). First results of the cooperative German/ Italian Pilot Study (central nervous system germ cell tumors). Klin Pediatr 209: 222–227

    Article  CAS  Google Scholar 

  19. Castaneda VL, Parmley RT, Geiser CF, Saldivar VA et al (1990) Postoperative chemotherapy for primary intracranial germ cell tumors. Med Ped Oncology 18: 299–303

    Article  CAS  Google Scholar 

  20. Chan H, Humphreys R, Hendrick B, Chuang S et al (1984) Primary intracranial choriocarcinoma: a report of two cases and a review of the literature. Neurosurgery 14: 540–545

    Article  Google Scholar 

  21. Chang TK, Wong TT, Huang B (1995) Combination chemotherapy with vinblastine, bleomycin, cisplatin and etoposide (VPBE) in children with primary intracranial germ cell tumors. Med Pediatr Oncol 24: 368–372

    Article  PubMed  CAS  Google Scholar 

  22. Constine LS, Woolf PD, Cann D et al (1993) Hypothalamic-pituitary dysfunction after radiation for brain tumors. N Engl J Med 328: 87–94

    Article  PubMed  CAS  Google Scholar 

  23. Cooper K, Bajorin D, Shapiro W et al (1990) Decompression of epidural metastases from germ cell tumors with chemotherapy. J Neuroncol 8: 275– 280

    Article  CAS  Google Scholar 

  24. Crossen JR, Garwood D, Glatstein E et al (1994) Neurobehavioral sequelae of cranial irradiation in adults: a review of radiation-induced encephalopathy. J Clin Oncol 12: 627–642

    PubMed  CAS  Google Scholar 

  25. Demeocq F, Baranzelli MC, Renier D et al (1988) Traitement des tumeurs germinales malignes intracraniennes de l’enfant. Presse Med 17: 2183– 2185

    PubMed  CAS  Google Scholar 

  26. Dodion P, Sanders C, Georgers P, Kenis Yet al (1988) In vitro chemosensitivity of brain tumors to cisplatin and its analogues, iproplatin and carboplatin. Cancer Chemother Pharmacol 22: 80–82

    Article  PubMed  CAS  Google Scholar 

  27. Duffner PK, Cohen ME, Thomas PR et al (1985) The long-term effects of cranial irradiation on the central nervous system. Cancer 56: 1841–1846

    Article  PubMed  CAS  Google Scholar 

  28. De Tribolet N, Barrelet L (1977) Successful chemotherapy of pinealoma. Lancet XX: 1228–1229

    Article  Google Scholar 

  29. Edwards MSB (1988) Pineal region tumours in children. J Neurosurg 68: 689– 697

    Article  PubMed  CAS  Google Scholar 

  30. Einhorn LH, Donohue J (1977) Cis-diamminedichloroplatinum, vinblastine and bleomycin combination chemotherapy in disseminated testicular cancer. Ann Intern Med 87: 293–298

    PubMed  CAS  Google Scholar 

  31. Ely an SAG, Traish D, Ashley S et al (1993) The management of primary CNS GCT with chemotherapy: Presented at the Third International Neurol-Oncology Conference, Royal Mardsden Hospital, London, England, April 1993

    Google Scholar 

  32. Gardner S, Dunkel I, Bayer L et al (1996) Autologous stem cell rescue using peripheral blood cells versus bone marrow in patients with recurrent malignant brain tumors. Exp Hematol 24: 1043 (abstr)

    Google Scholar 

  33. Flamant F, Baranzelli MC, Lemerle J (1990) Treatment of malignant germ cell tumors in children: experience of the Institute Gustave Roussy and the French Society of Pediatric Oncology. Crit Rev Oncol Hematol 10: 90–110

    Article  Google Scholar 

  34. Gaynon P, Ettinger L, Baum E et al (1990) Carboplatin in childhood brain tumors. A children’s cancer study group phase II trial. Cancer 66: 2465– 2469

    Article  PubMed  CAS  Google Scholar 

  35. Ginsberg S, Kirshner J, Reich S et al (1981) Systemic chemotherapy for a primary germ cell tumor of the brain — a pharmacokinetic study. Cancer Treat rep 65: 477–483

    PubMed  CAS  Google Scholar 

  36. Graziano S, Paolozzi F, Rudolph A et al (1987) Mixed germ cell tumors of the pineal region. Case report. J Neurosurg 66: 300–304

    Article  PubMed  CAS  Google Scholar 

  37. Haase J, Nielsen K (1979) Value of tumor markers in the treatment of endodermal sinus tumors and choriocarcinomas in the pineal region. Neurosurgery 5: 485–488

    Article  PubMed  CAS  Google Scholar 

  38. Hayashida O, Kageyama N, Ogata N, Okumura T et al (1989) Combination chemotherapy with etoposide and cisplatin to intracranial germ cell tumors: a preliminary report. Pediatr Neurosurg 14: 150–151 (abstr)

    Google Scholar 

  39. Hermann H, Westphal M, Winkler K et al (1994) Treatment of nongerminomatous germ-cell tumors of the pineal region. Neurosurgery 34: 524– 529

    Article  Google Scholar 

  40. Hoffman HJ, Otsubo H, Hendrick EB et al (1991) Intracranial germ cell tumors in children. J Neurosurg 74: 545–551

    Article  PubMed  CAS  Google Scholar 

  41. Itoyama Y, Kochi M, Kuratsu J et al (1995) Treatment of intracranial non-germinomatous malignant germ cell tumors producing alfa-fetoprotein. Neurosurgery 36: 459–464

    Article  PubMed  CAS  Google Scholar 

  42. Jelsma RK, Carroll M (1989) Brain metastasis from non seminomatous germ cell tumors of the testis: case report and review of the role of surgery. Neurosurgery 25: 814–819

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  44. Jereb B, Zupancic N, Petric J (1990) Intracranial germinoma: report of seven cases. Pediatr Hematol Oncol 7: 183–88

    Article  PubMed  CAS  Google Scholar 

  45. Jeremic B, Grujicic D, Jevremovic S et al (1992) Carboplatin and etoposide chemotherapy regimen for recurrent malignant gliomas: a phase II study. J Clin Oncol 10: 1074–1077

    PubMed  CAS  Google Scholar 

  46. Kalifa C (1997) Personal communication

    Google Scholar 

  47. Kida Y, Kobayashi T, Yoshida J et al (1986) Chemotherapy with cisplatin for AFP-secreting germ-cell tumors of the central nervous system. J Neurosurg 65: 470–475

    Article  PubMed  CAS  Google Scholar 

  48. Kobayashi T, Yoshida J, Ishimaya J et al (1989) Combination chemotherapy with cisplatin and etoposide for malignant intracranial germ cell tumors: an experimental and clinical study. J Neurosurg 70: 676–681

    Article  PubMed  CAS  Google Scholar 

  49. Kobayashi T, Yoshida J, Sugita K et al (1989) Combination chemotherapy with cisplatin and etoposide for intracranial germ cell tumors. Pediatr Neurosurg 24: 150

    Google Scholar 

  50. Kretschmar CS (1997) Germ cell tumors of the brain in children: a review of current literature and advances in therapy. Cancer Investigation 15: 187–198

    Article  PubMed  CAS  Google Scholar 

  51. Lee ACW, Chan GCF, Fung CF et al (1995) Paradoxical response of a pineal immature teratoma to combination chemotherapy. Medical and Pediatric Oncol 24: 53–57

    Article  CAS  Google Scholar 

  52. Li FP, Cassady JR, Jaffe N (1975) Risk of second tumors in survivors of childhood cancer. Cancer 35: 1230–1235

    Article  PubMed  CAS  Google Scholar 

  53. Logothetis CJ, Samuels ML, Trindade A (1982) The management of brain metastases in germ cell tumors. Cancer 49: 12–18

    Article  PubMed  CAS  Google Scholar 

  54. Mahoney D, Strather D, Carmitta B et al (1996) High-dose melphalan and cyclophosphamide with autologous bone marrow rescue for recurrent/progressive malignant brain tumors in children: a pilot Pediatric Oncology Group study. J Clin Oncol 14: 382–388

    PubMed  CAS  Google Scholar 

  55. Matsukado Y (1986) The Japanese intracranial germ cell tumor study group: cisplatin, vinblastine, and bleomycin (PVB) combination chemotherapy in the treatment of intracranial malignant germ cell tumors — a preliminary report of a phase II study. Gan No Rinsho 32: 1387–1393

    PubMed  CAS  Google Scholar 

  56. Matsutani M, Takakura K, Sano K (1987) Primary intracranial germ cell tumors: pathology and treatment. Prog Exp Tumor Res 30: 307–312

    PubMed  CAS  Google Scholar 

  57. Matsutani, Asai A, Fujimaki T, Nakamura O (1993) Successful treatment of recurrent malignant germ cell tumors: report of two cases. Neurosurgery 33: 901–906

    Article  PubMed  CAS  Google Scholar 

  58. Matsutani M, Sano K, Takakura K et al (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86: 446–455

    Article  PubMed  CAS  Google Scholar 

  59. Modak S, Gardner S, Dunkel I et al (1997) High dose chemotherapy with autologous stem cell rescue in patients with recurrent central nervous system germ cell tumors. Presented at: Childhood Cancer into the 21st Century: An international conference to mark the 20th anniversary of the UKCCSG, London, United Kingdom, March 1997

    Google Scholar 

  60. Motzer R, Mazumdar M, Bosl G et al (1996) High-dose carboplatin, etoposide and cyclophosphamide for patients with refractory germ cell tumors: treatment results and prognostic factors for survival and toxicity. J Clin Oncol 14: 1098–1105

    PubMed  CAS  Google Scholar 

  61. Motzer R, Gulati S, Crown J et al (1990) High-dose chemotherapy and autologous bone marrow rescue for patients with refractory germ cell tumors: early intervention is better tolerated. Cancer 69: 550–556

    Article  Google Scholar 

  62. Murphy BA, Motzer RJ, Mazumdar M et al (1994) Serum tumor marker decline is an early predictor of treatment outcome in germ cell tumor patientstreated with cisplatin and ifosfamide salvage chemotherapy. Cancer 73:2520–2526

    Article  PubMed  CAS  Google Scholar 

  63. Nashold JRB, Oakes WJ, Friedman HS et al (1994) Management of pineal non-germinoma germ cell tumor with residual teratoma and normal alphafetoprotein. Med Pediatr Oncol 22: 137–139

    Article  PubMed  CAS  Google Scholar 

  64. Nichols C, Andersen J, Lazarus H et al (1992) High-dose carboplatin and etoposide with autologous bone marrow transplantation in refractory germ cell cancer: an Eastern Cooperative Oncology Group protocol. J Clin Oncol 10: 558–563

    PubMed  CAS  Google Scholar 

  65. Oi S, Matsumoto S (1992) Controversy pertaining to the therapeutic modalities for tumors of the pineal region: worldwide survey of different patient populations. Child Nervous System 8: 332–336

    Article  CAS  Google Scholar 

  66. Packer R, Sutton L, Rorke L et al (1984) Intracranial embryonal carcinoma. Cancer 54: 520–524

    Article  PubMed  CAS  Google Scholar 

  67. Patel S, Buckner JC, Smithson WA, et al (1992) Cisplatin-based chemotherapy in primary central nervous system germ cell tumors. J Neuro-Oncol 12: 47–52

    Article  CAS  Google Scholar 

  68. Pinkerton CR, Broadbent V, Horwich A et al (1990) ‘JEB’ - a carboplatin based regimen for malignant germ cell tumors in children. Br J Cancer 62: 267–262

    Article  Google Scholar 

  69. Plowman N, Sebag-Montefiore D, Kingston J (1993) “Central nervous system friendly” chemotherapy for the treatment of intracranial germ cell tumors. Proc ASCO 12: 177 (abstr)

    Google Scholar 

  70. Robertson PL, DaRosso RC, Allen JC (1997) Improved modality of intracranial non-germinoma germ cell tumors with multimodality therapy. J Neuro-Oncol 32: 71–80

    Article  CAS  Google Scholar 

  71. Rustin GJS, Newlands ES, Bagshawe KD et al (1986) Successful management of metastatic and primary germ cell tumors in the brain. Cancer 57: 2108–2113

    Article  PubMed  CAS  Google Scholar 

  72. 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

    Article  PubMed  CAS  Google Scholar 

  73. Salazar OM, Castro-Vita H, Bakos RS, Feldstein ML, Rubin P (1979) Radiation therapy for tumors of the pineal region. Int J Radiat Oncol Biol Phys 5: 491– 499

    Article  PubMed  CAS  Google Scholar 

  74. Siegal T, Pfeffer R, Catane et al (1983) Successful chemotherapy of recurrent intracranial germinoma with spinal metastases. Neurology 33: 631–633

    PubMed  CAS  Google Scholar 

  75. Siegert W, Beyer J, Strohscheer I et al (1994) High-dose carboplatin, etoposide and ifosfamide followed by autologous stem-cell transplantation in relapsed or refractory germ-cell cancer: a phase II study. J Clin Oncol 12: 1223–1231

    PubMed  CAS  Google Scholar 

  76. Skinner R (1993) Treatment of intracranial non-germinomatous germ cell tumors in children with chemotherapy alone. Presented at the Third International Neuro-Oncology Conference, Royal Mardsden Hospital, London, England, April 1993

    Google Scholar 

  77. Spiegel AM, Di Chiro G, Gorden P et al (1976) Diagnosis of radiosensitive hypothalamic tumors without craniotomy. Ann Intern Med 85: 290–293

    PubMed  CAS  Google Scholar 

  78. Thomas G (1985) Controversies in the management of testicular seminoma. Cancer 5: 2296–2302

    Article  Google Scholar 

  79. Watterson J, Priest JR (1989) Control of extraneural metastasis of a primary intracranial nongerminomatous germ-cell tumor. J Neurosurg 71: 601–604

    Article  PubMed  CAS  Google Scholar 

  80. Williams SD, Birch R, Einhorn LH et al (1987) Treatment of disseminated germ cell tumors with chemotherapy with cisplatin, bleomycin, and either vinblastine or etoposide. N Engl J Med 316: 1435–1440

    Article  PubMed  CAS  Google Scholar 

  81. Wolden SL, Wara WM, Larson DA et al (1995) Radiation therapy for primary intracranial germ-cell tumors. Int J Radiat Oncol Biol Phys 32: 943–947

    Article  PubMed  CAS  Google Scholar 

  82. Yoshida J, Sugita K, Kobayashi T et al (1993) Prognosis of intracranial germ cell tumors: effectiveness of chemotherapy with cisplatin and etoposide (CDDP and VP-16). Acta Neurochir (Wien) 120: 111–117

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurological Institute, Columbia Presbyterian Medical Center, New York, NY, USA

    C. Balmaceda

  2. Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    S. Modak

  3. Division of Pediatric Oncology, New York University Medical Center, New York, NY, USA

    J. Finlay

Authors
  1. C. Balmaceda
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Modak
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J. Finlay
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan

    Yutaka Sawamura

  2. Department of Radiology, Hokkaido University School of Medicine, Sapporo, Japan

    Hiroki Shirato

  3. Service de Neurochirurgie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland

    Nicolas de Tribolet

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer-Verlag/Wien

About this chapter

Cite this chapter

Balmaceda, C., Modak, S., Finlay, J. (1998). Chemotherapy for CNS GCTs. In: Sawamura, Y., Shirato, H., de Tribolet, N. (eds) Intracranial Germ Cell Tumors. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6821-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-7091-6821-9_11

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7414-2

  • Online ISBN: 978-3-7091-6821-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation