Radiotherapy for CNS GCTs

  • H. Shirato


At the time when open surgeries for pineal and hypothalamic-neurohypophyseal tumors showed high morbidity and mortality, irradiation was often used to determine the radiosensitivity of the tumor without histological confirmation. However, there is no longer any justification for the use of “diagnostic radiotherapy” or “radiation tests” in order to inspect the histologic nature of pineal and neurohypophyseal lesions. Radiotherapy should not be given before attempting to verify a tumor histology. Although the number of papers which stress the importance of histological diagnosis by surgery has been increasing, until recently the actual percentage of pathological verification before irradiation has been unsatisfactory in Japan [6]. Radiation oncologists should, therefore, encourage neurosurgeons to perform diagnostic or resection surgery for pineal and neurohypophyseal tumors. The reason for this recommendation will be described below.


Germ Cell Tumor Mature Teratoma Immature Teratoma Craniospinal Irradiation Partial Brain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Abey IIEO, Laws ER, Grado GL, Bruckman JE, Forbes GS, Gomez MR, Scott M (1981) Pineal tumors in children and adolescents. J Neurosurg 55: 889–895CrossRefGoogle Scholar
  2. 2.
    Alexander III E, Loeffler JS, Lunsford LD (1993) Stereotactic radiosurgery. McGraw-Hill, New YorkGoogle Scholar
  3. 3.
    Allen JC, DaRosso RC, Donahue B, Nirenberg A (1994) A phase II trial of preirradiation carboplatin in newly diagnosed germinoma of the central nervous system. Cancer 74: 940–944PubMedCrossRefGoogle Scholar
  4. 4.
    Allen JC, Kim JH, Packer RJ (1987) Neoadjuvant chemotherapy for newly diagnosed germ cell tumors of the central nervous system. J Neurosurg 67: 65–70PubMedCrossRefGoogle Scholar
  5. 5.
    Amendola BE, McClatchey K, Amendola MA (1984) Pineal region tumors: analysis of treatment results. Int J Radiat Oncol Biol Phys 10: 991–997PubMedCrossRefGoogle Scholar
  6. 6.
    Aoyama H, Shirato H, Kakutou Y, Inakoshi H, Nishio M, Yoshida H, Hareyama M, Yanagisawa T, Watarai J, Miyasaka K (1998) Pathologically-proven intracranial germinoma treated with radiation therapy. Radiother Oncol (in press)Google Scholar
  7. 7.
    Aoyama H, Shirato H, Yoshida H, Hareyama M, Nishio M, Yanagisawa T, Kakutou Y, Watarai J, Inakoshi H, Miyasaka K (1998) Intracranial non-germinomatous germ cell tumors. Radiother Oncol (in press)Google Scholar
  8. 8.
    Aydin F, Ghatak NR, Radie-Keane K, Kinard J, Land SD (1992) The short-term effect of low-dose radiation on intracranial germinoma. A pathologic study. Cancer 69: 2322–2326PubMedCrossRefGoogle Scholar
  9. 9.
    Ball D, Barret A, Peckman MJ (1982) The management of metastatic seminoma testis. Cancer 50: 2294CrossRefGoogle Scholar
  10. 10.
    Balmaceda C, Heller G, Rosenblum M, Diez B, Vlllablanca JG, Kellie S, Maher P, Vlamis V, Walker RW, Leibel S, Finley JL (1996) Chemotherapy without irradiation - A novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. J Clin Oncol 14: 2908–2915PubMedGoogle Scholar
  11. 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: 229–239CrossRefGoogle Scholar
  12. 12.
    Bayens YC, Helle PA, Van Putten WL, Mali SPM (1992) Orchidectomy followed by radiotherapy in 176 stage I and II testicular seminoma patients: benefits of a 10-year follow-up study. Radiother Oncol 25: 97–102PubMedCrossRefGoogle Scholar
  13. 13.
    Bjornsson J, Scheithauer BW, Okazaki H, Leech RW (1985) Intracranial germ cell tumors: Pathobiological and immunohistochemical aspects of 70 cases. J Neuropathol Exp Neurol 44: 32–46PubMedCrossRefGoogle Scholar
  14. 14.
    Bloom HJG (1983) Primary intracranial germ cell tumours. Clinics in Oncology 2: 233–257Google Scholar
  15. 15.
    Brada M, Laing R (1994) Radiosurgery/stereotactic external beam radiotherapy for malignant brain tumours: the Royal Marsden Hospital experience. Recent Results in Cancer Research 135: 91–104PubMedGoogle Scholar
  16. 16.
    Brada M, Rajan B (1990) Spinal seeding in cranial germinoma. Br J Cancer 61: 339–340PubMedCrossRefGoogle Scholar
  17. 17.
    Brewster L, Mohan R, Mageras G, Burman C, Leibel S, Fuks Z (1995) Three dimensional conformal treatment planning with multileaf collimators. Int J Radiat Oncol Biol Phys 33: 1081–1089PubMedCrossRefGoogle Scholar
  18. 18.
    Calaminus G, Bamberg M, Baranzelli MC, Benoit Y, di Montezemolo LC, Fossati-Bellani F, Jurgens H, Kuhl HJ, Lenard HG, Lo Curto M, Mann JR, Patte C, Pearson A, Perilongo G, Schmidt D, Schober R, Gobel U (1994) Intracranial germ cell tumors: a comprehensive update of the European data. Neuropedia-trics 25: 26–32CrossRefGoogle Scholar
  19. 19.
    Camins MB, Mount LA (1974) Primary Suprasellar atypinal teratoma. Brain 97: 447–456PubMedCrossRefGoogle Scholar
  20. 20.
    Castro JR, Phillips TL, Prados M, Gutin P, Larson DA, Petti PL, Daftari IK, Collier JM, Lillis-Hearne P (1997) Neon heavy charged particle radiotherapy of glioblastoma of the brain. Int J Radiat Oncol Biol Phys 38: 257–261PubMedCrossRefGoogle Scholar
  21. 21.
    Chao CK, Lee ST, Lin FJ, Tang SG, Leung WM (1993) A multivariate analysis of prognostic factors in management of pineal tumor. Int J Radiat Oncol Biol Phys 27: 1185–9111PubMedCrossRefGoogle Scholar
  22. 22.
    Dattoli MJ, Newall J (1990) Radiation therapy for intracranial germinoma: the case for limited volume treatment. Int J Radiat Oncol Biol Phys 19: 429–433PubMedCrossRefGoogle Scholar
  23. 23.
    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: 773–781PubMedCrossRefGoogle Scholar
  24. 24.
    Dunbar SF, Barnes PD, Tarbeil NJ (1993) Radiologic determination of the caudal border of the spinal field in cranial spinal irradiation. Int J Radiat Oncol Biol Phys 26: 669–673PubMedCrossRefGoogle Scholar
  25. 25.
    Edwards MSB, Hudgins RJ, Wilson CB, Levin VA, Wara WM (1988) Pineal region tumors in children. J Neurosurg 68: 689–697PubMedCrossRefGoogle Scholar
  26. 26.
    Endo M, Koyama-Ito H, Minohara S, Miyahara N, Tomura H, Kanai T, Kawachi K, Tsujii H, Morita K (1996) Hiplan-A heavy ion treatment planning system at HIMAC. 8: 231–238Google Scholar
  27. 27.
    Fields JN, Fulling KH, Thomas PR, Marks JE (1987) Suprasellar germinoma: radiation therapy. Radiology 164: 247–249PubMedGoogle Scholar
  28. 28.
    Fields KK, Elfenbein GJ, Lazarus HM, Cooper BW, Perkins JB, Creger RJ, Ballester OF, Hiemenz JH, Jansenn WE, Zorsky PE (1995) Maximum-tolerated does of ifosfamide, carboplatin, and etoposide given over 6 days followed by autologous stem-cell rescue: toxicity profile. J Clin Oncol 13: 323–332PubMedGoogle Scholar
  29. 29.
    Fuller BG, Kapp DS, Cox R (1994) Radiation therapy of pineal region tumors: 25 new cases and a review of 208 previously reported cases. Int J Radiat Oncol Biol Phys 28: 229–245PubMedCrossRefGoogle Scholar
  30. 30.
    Garre ML, El-Hossainy MO, Fondelli P, Gobel U, Brisigotti M, Donati PT, Nantron M, Ravegnani M, Garaventa A, Bernardi BD (1996) Is chemotherapy effective therapy for intracranial immature teratoma? Cancer 77: 977–982PubMedCrossRefGoogle Scholar
  31. 31.
    Graziano SL, Paolozzi FP, Rudolph AR, Stewart WA, Elbadawi A, Comis RL (1987) Mixed germ-cell tumor of the pineal region: case report. J Neurosurg 66: 300–304PubMedCrossRefGoogle Scholar
  32. 32.
    Griffin BR, Griffn TW, Tong DYK, Russell AH, Kurtz J, Laramore GE, Groudine M (1981) Pineal region tumors: results of radiation therapy and indications for elective spinal irradiation. Int J Radiat Oncol Biol Phys 7: 605–608PubMedCrossRefGoogle Scholar
  33. 33.
    Haddock MG, Schild SE, Scheithauer BW, Schomberg PJ (1997) Radiation therapy for histologically confirmed primary central nervous system germi-noma. Int J Radiat Oncol Biol Phys 38: 915–923PubMedCrossRefGoogle Scholar
  34. 34.
    Halperin EC (1993) Concerning the inferior portion of the spinal radiotherapy field for malignancies that disseminate via the cerebrospinal fluid. Int J Radiat Oncol Biol Phys 1993: 357–362Google Scholar
  35. 35.
    Hardenbergh PM, Golden J, Billet A, Scott RM, Shrieve DC, Silver B, Loeffler JS, Tarbell NJ (1997) Intracranial germinoma: the case for lower dose radiation therapy. Int J Radiat Oncol Biol Phys 39: 419–426PubMedCrossRefGoogle Scholar
  36. 36.
    Herrman HD, Westphal M, Winkler K, Lass RW, Schulte FJ (1994) Treatment of nongerminomatous germ-cell tumors of the pineal region. Neurosurgery 34: 524–529CrossRefGoogle Scholar
  37. 37.
    Hoffman HJ, Otsubo H, Hendrick EB, Humphreys RP, Drake JM, Becker LE, Greenberg M, Jenkin D (1991) Intracranial germ-cell tumors in children. J Neurosurg 74: 545–51PubMedCrossRefGoogle Scholar
  38. 38.
    Hounsfield GH (1973) Computerized transverse axial scanning (tomography), part 1 Description of system. Br J Radiol 46: 1016–1022PubMedCrossRefGoogle Scholar
  39. 39.
    Huh SJ, Shin KH, Kim IH, Ahn YC, Ha SW, Park CI (1996) Radiotherapy of intracranial germinomas. Radiother Oncol 38: 19–23PubMedCrossRefGoogle Scholar
  40. 40.
    Itoyama Y, Kochi M, Yamashiro S, Yoshizato K, Kuratsu J, Ushio Y (1993) Combination chemotherapy with cisplatin and etoposide for hematogenous spinal metastasis of intracranial germinoma - case report. Neurologia Medico-Chirurgica 33: 28–31PubMedCrossRefGoogle Scholar
  41. 41.
    Jenkin D, Berry M, Chan H (1990) Pineal region germinomas in childhood treatment consideration. Int J Radiat Oncol Biol Phys 18: 541–545PubMedCrossRefGoogle Scholar
  42. 42.
    Jennings MT, Gelman R, Hochberg F (1985) Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg 63: 155–167PubMedCrossRefGoogle Scholar
  43. 43.
    Jereb B, Zupancic N, Petric J (1990) Intracranial germinoma: report of seven cases. Pediatr Hematol Oncol 7: 183–188PubMedCrossRefGoogle Scholar
  44. 44.
    Kawachi K, Kanai T, Endo M, Hirao Y, Tsunemoto H (1989) Radiation oncological facilities of the HIMAC. J Jpn Soc Ther Radiol Oncol 1: 19–29Google Scholar
  45. 45.
    Kawashima K, Shirato H, Takamura A, Shinohara N, Sawamura Y, Miyasaka K (1997) Stereotactic irradiation using a linear accelerator for brain metastasis from renal cell carcinoma. Int J Clin Oncol 2: 73–76CrossRefGoogle Scholar
  46. 46.
    Kersh CR, Constable WC, Eisert DR, Spaulding CA, Hahn SS, Jenrette JMD, Marks RD Jr (1988) Primary central nervous system germ cell tumors. Effect of histologic confirmation on radiotherapy. Cancer 61: 2148–52PubMedCrossRefGoogle Scholar
  47. 47.
    Khoo VS, Dearnaley DP, Finnigan DJ, Padhani A, Tanner SF, Leach MO (1997) Magnetic resonance inmagin (MRI): considerations and applications in radiotherapy treament planning. Radiother Oncol 42: 1–15PubMedCrossRefGoogle Scholar
  48. 48.
    Kida Y, Kobayashi T, Yoshida J, Kato K, Kageyama N (1986) Chemotherapy with cisplatin for AFP-secreting germ-cell tumors of the central nervous system. J Neurosurg 65: 470–475PubMedCrossRefGoogle Scholar
  49. 49.
    Kiltie AE, Gattamaneni HR (1995) Survival and quality of life of paediatric intracranial germ cell tumour patients treated at the Christie Hospital, 1972–1993. Med Pediatr Oncol 25: 450–456PubMedCrossRefGoogle Scholar
  50. 50.
    Kirkove CS, Brown AP, Symon L (1991) Successful treratment of a pineal endodermal sinus tumor. Case report. J Neurosurg 74: 832–836PubMedCrossRefGoogle Scholar
  51. 51.
    Kitahara T, Shirato H, Nishioka T, Kagei K, Yamaguchi M, Furuya T, Watanabe Y, Takekawa N, Miyasaka K (1998) A new mold material for customized patient positioning in radiotherapy. Radiother Oncol (in press)Google Scholar
  52. 52.
    Legido A, Packer RJ, Sutton LN, D’Angio G, Rorke LB, Bruce D A, Schut L (1989) Suprasellar germinoma in children. A reappraisal. Cancer 63: 340–344PubMedCrossRefGoogle Scholar
  53. 53.
    Linstadt D, Wara WM, Edwards MS, Hudgins RJ, Sheline GE (1988) Radiotherapy of primary intracranial germinomas: the case against routine craniospinal irradiation. Int J Radiat Oncol Biol Phys 15: 291–297PubMedCrossRefGoogle Scholar
  54. 54.
    Loeffler JS, Kooy HM, Wen PY, Fine HA, Cheng C-W, Mannarino EG, Tsai JS, Alexander E III (1990) The treatment of recurrent brain metastasis with stereotactic radiosurgery. J Clin Oncol 8: 576–582PubMedGoogle Scholar
  55. 55.
    Matsutani M (1992) Long-term follow-up of patients with primary intracranial germinomas. In: Packer R, Bleyer WL, Pchedly C (eds) Pediatric Neuro-Oncology. Harwood Academic Pub, Chur, Philadelphia, pp 254–260Google Scholar
  56. 56.
    Matsutani M, Sano K, Takakura K, Fujimaki T, Nakamura O, Funata N, Seto T (1997) Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg 86: 446–455PubMedCrossRefGoogle Scholar
  57. 57.
    Matsutani M, Takakura K, Sano K (1987) Primary intracranial germ cell tumors: pathology and treatment. Progress in Experimental Tumor Research 30: 307–12PubMedGoogle Scholar
  58. 58.
    McAllister B, Archambeau JO, Nguyen MC, Slater JD, Loredo L, Schulte R, Alvarez O, Bedros AA, Keleita T, Moyers M, Miller D, Slater JM (1997) Proton therapy for pediatric cranial tumors: preliminary report on treatment and disease-related morbidities. Int J Radiat Oncol Biol Phys 39: 455–460PubMedCrossRefGoogle Scholar
  59. 59.
    Murovic JA, Ongley JP, Parker JC Jr, Page LK (1981) Manifestations and therapeutic considerations in pineal yolk-sac tumors. Case report. J Neurosurg 55: 303–307PubMedCrossRefGoogle Scholar
  60. 60.
    Nagata Y, Okajima K, Murata R, Mitsumori M, Mizowaki T, Tsutsui K, Ono K, Nishimura Y, Hiraoka M, Nishidai T, Takahashi M, Abe M (1994) Three-dimentional treatment planning for maxillary cancer using a CT simulator. Int J Radiat Oncol Biol Phys 30: 979–983PubMedGoogle Scholar
  61. 61.
    Nakamoto S, Mitsuhashi N, Takahashi T, Sakurai H, Niibe H (1996) An interaction of cisplatin and radiation in two rat yolk sac tumour cell lines with different radiosensitivities in vitro. Int J Radiat Biol 70: 747–753PubMedCrossRefGoogle Scholar
  62. 62.
    Olshan JS, Gubernick J, Packer RJ, D’Angio G, Goldwein JW, Willi SM, Moshang J (1992) The effects of adjuvant chemotherapy on growth in children with medulloblastoma. Cancer 70: 2013–2017PubMedCrossRefGoogle Scholar
  63. 63.
    Ono N, Isobe I, Uki J, Kurihara H, Shimizu T, Kohno K (1994) Recurrence of primary intracranial germinomas after complete response with radiotherapy: recurrence patterns and therapy. Neurosurgery 35: 615–621PubMedCrossRefGoogle Scholar
  64. 64.
    Ono N, Kakegawa T, Zama A, Nakamura M, Inoue HK, Tamura M, Wakao T, Uki J, Takeda F, Kurihara H, Shimizu T, Handa I (1994) Factors affecting functional prognosis in survivors of primary central nervous system germinal tumors. Surg Neurol 41: 9–15PubMedCrossRefGoogle Scholar
  65. 65.
    Packer RJ, Sutton LN, Rorke LB, Rosenstock JG, Zimmerman RA, Litman P, Bilaniuk LT, Bruce DA, Schut L (1984) Intracranial embryonal cell carcinoma. Cancer 1984: 520–524CrossRefGoogle Scholar
  66. 66.
    Rasch C, Keus R, Pameijer FA, Koops W, de Ru V, Muller S, Touw A, Bartelink H, van Herk M, Lebesque JV (1997) The potential impact of CT-MRI matching on tumor volume delineation in advanced head and neck cancer. Int J Radiat Onco Biol Phys 39: 841–848CrossRefGoogle Scholar
  67. 67.
    Robertson PL, DaRosso RC, Allen JC (1997) Improved prognosis of intracranial non-germinoma gerl cell tumors with multimodality therapy. J Neuro-Oncol 32: 71–80CrossRefGoogle Scholar
  68. 68.
    Sakai N, Yamada H, Andoh T, Nishimura Y, Niikawa S (1993) Long-term survival in malignant intracranial germ-cell tumors: a report of two cases and a review of the literature. Childs Nervous System 9: 431–6CrossRefGoogle Scholar
  69. 69.
    Salazar OM, Castro-Vita H, Bakos RS, Feldstein LM, Keller B, Rubin P (1979) Radiation therapy for tumors of the pineal region. Int J Radiat Oncol Biol Phys 5: 491–499PubMedCrossRefGoogle Scholar
  70. 70.
    Sawamura Y (1996) Current diagnosis and treatment of central nervous system germ cell tumours. Curr Opin in Neurol 9: 419–423CrossRefGoogle Scholar
  71. 71.
    Sawamura Y, Shirato H, Ikeda J, Tada M, Ishii N, Kato T, Abe H, Fujieda K (1998) Induction chemotherapy followed by reduced-volume Irradiation for newly diagnosed CNS germinoma. J Neurosurg 88: 66–72PubMedCrossRefGoogle Scholar
  72. 72.
    Schild SE, Haddock MG, Scheithaauer BW, Marks LB, Norman MG, Burger PC, Wong WW, Lyons MK, Schomberg PJ (1996) Nongerminomatous germ cell tumors of the brain. Int J Radiat Oncol Biol Phys 36: 557–563PubMedCrossRefGoogle Scholar
  73. 73.
    Senan S, Rammpling R, Kaye SB (1991) Malignant pineal teratomas: a report on three patients and the case for craniospinal irradiation following chemotherapy. Radiater Oncol 22: 209–213CrossRefGoogle Scholar
  74. 74.
    Shibamoto Y, Oda Y, Yamashita J, Takahashi M, Kikuchi H, Abe M (1994) The role of cerebrospinal fluid cytology in radiotherapy planning for intracranial germinoma. Int J Radiat Oncol Biol Phys 29: 1089–1094PubMedCrossRefGoogle Scholar
  75. 75.
    Shibamoto Y, Takahashi M, Abe M (1994) Reduction of the radiation dose for intracranial germinoma: a prospective study. Br J Cancer 70: 984–989PubMedCrossRefGoogle Scholar
  76. 76.
    Shibamoto Y, Takahashi M, Sasai K (1997) Prognosis of intracranial germinoma with syncytiotrophoblastic giant cells treated by radiation therapy. Int J Radiat Oncol Biol Phys 37: 505–510PubMedCrossRefGoogle Scholar
  77. 77.
    Shirato H, Matsuoka Y, Miyamoto M, Kamada T, Arimoto T, Mizoe J, Tsujii H, Irie G (1985) Radiotherapy of pineal tumors and ectopic pinealomas. Nippon Acta Radiol 25: 348–355Google Scholar
  78. 78.
    Shirato H, Nishio M, Sawamura Y, Myohjin M, Kitahara T, Nishioka T, Mizutani Y, Abe H, Miyasaka K (1997) Analysis of long-term treatment of intracranial germinoma. Int J Radiat Oncol Biol Phys 37: 511–515PubMedCrossRefGoogle Scholar
  79. 79.
    Shirato H, Suzuki K, Nishioka T, Kamada T, Kagei K, Kitahara T, Morisawa H, Tsujii H (1994) Precise positioning of intracranial small tumors to the linear accelerator’s isocenter, using a stereotactic radiotherapy computed tomography system (SRT-CT). Radiater Oncol 32: 180–183CrossRefGoogle Scholar
  80. 80.
    Shirato H, Takaumura A, Tomita MKS, Nishioka T, Isu T, Kato T, Sawamura Y, Miyamachi K, Abe H, Miyasaka K (1997) Stereotactic irradiation without whole brain irradiation for single brain metastasis. Int J Radiat Oncol Biol Phys 37: 385–391PubMedCrossRefGoogle Scholar
  81. 81.
    Somaza S, Kondziolka D, Lunsford LD, Kirkwood JM, Flickinger JC (1993) Stereotactic radiosurgery for cerebral metastatic melanoma. J Neurosurg 79: 661–666PubMedCrossRefGoogle Scholar
  82. 82.
    Sugiyama K, Uozumi T, Arita K, Kiya K, Kurisu K, Sumida M, Harada K (1994) Clinical evaluation of 33 patients with histologically verified germi-noma. Surg Neurol 42: 200–210PubMedCrossRefGoogle Scholar
  83. 83.
    Sung DI, Harisiadis L, Chang CH (1978) Midline pineal tumors and suprasellar germinomas: highly curable by irradiation. Radiology 128: 745–751PubMedGoogle Scholar
  84. 84.
    Thomas GM, Rider WD, Dembo AJ, Cummings B J, Gospoarowics M, Hawkins NV, Herman JG, Keen CW (1982) Seminoma of the testis: results of treatment and patterns of faiure after radiation therapy. Int J Radiat Oncol Biol Phys 8: 165–174PubMedCrossRefGoogle Scholar
  85. 85.
    Wara WM, Jenkin, DT, Evans A, Ertel I, Hittle R, Ortega J, Wilson CB, Hammond D (1979) Tumors of the pineal and supraselar region: childrens cancer study group treatment results 1960–1975. A Report from Children Cancer Study Group. Cancer 43: 698–701PubMedCrossRefGoogle Scholar
  86. 86.
    Wara WM, Carol F, Sheline GE (1977) Radiation therapy for pineal tumors and suprasellar germinomas. Radiology 124: 221–223PubMedGoogle Scholar
  87. 87.
    Whang C, Kwon Y (1995) Gamma knife radiosurgery for malignant tumors. J Korean Med Sci 10: 379–387PubMedGoogle Scholar
  88. 88.
    Wolden SL, Wara WM, Larson DA, Prados MD, Edwards MS, Sneed PK Radiation therapy for primary intracranial germ-cell tumors. Int J Radiat Oncol Biol Phys 32: 943–949PubMedCrossRefGoogle Scholar
  89. 89.
    Yoshida J, Sugita K, Kobayashi T, Takakura K, Shitara N, Matsutani M, Tanaka R, Nagai H, Yamada H, Yamashita J (1993) Prognosis of intracranial germ cell tumours: effectiveness of chemotherapy with cisplatin and etoposide (CDDP and VP-16). Acta Neurochir (Wien) 120: 111–117CrossRefGoogle Scholar
  90. 90.
    Rich TA, Cassady JR, Strand RD, Winston KR (1985) Radiation therapy for pineal and suprasellar germ cell tumors. Cancer 55: 932–940PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1998

Authors and Affiliations

  • H. Shirato
    • 1
  1. 1.Section of Radiation Oncology, Department of RadiologyHokkaido University School of MedicineSapporoJapan

Personalised recommendations