Outcomes of Combined Chemotherapy and Limited-Dose Radiotherapy in Pineal Germinoma: A Retrospective Analysis from the National Oncology Institute, Rabat, Morocco


Authors : Chraa Fatima Zahra; C. Ezzouitina; R. Laraichi; K. Nouni; A. Lachgar; H. El Kacemi; T. Kebdani; K. Hassouni

Volume/Issue : Volume 9 - 2024, Issue 12 - December

Google Scholar : https://tinyurl.com/2bd4psne

Scribd : https://tinyurl.com/yrp9sx3y

DOI : https://doi.org/10.5281/zenodo.14709722

Abstract : Central nervous system germ cell tumors are rare tumors, most often located in the pineal region. This study aims to conduct a retrospective analysis of a series of patients treated for germinoma of the pineal gland.  Materials and Methods In 2020, six consecutive patients were treated for pineal gland germinoma at the National Oncology Institute in Rabat, Morocco. The diagnosis was confirmed histologically through stereotactic biopsy in five patients, while one patient was diagnosed based on biological (alpha-fetoprotein [AFP] and beta-human chorionic gonadotropin [B-HCG] levels), radiological, and therapeutic criteria. The median age was 22.4 years (range: 13–29 years). All patients received a combination of chemotherapy with four cycles of cisplatin and etoposide, followed by focal irradiation at 40 Gy (24 Gy to the ventricular system with a 16 Gy boost on the tumor residue).  Results and Statistical Analysis Five patients achieved complete remission, and one patient showed a partial response (74% reduction in pineal mass volume). All patients were alive without local recurrence after a median follow-up of 26 months.  Conclusion Pineal gland germ cell tumors have an excellent prognosis due to their radiosensitivity and chemosensitivity. Current treatment for pineal germinoma includes initial chemotherapy followed by limited-dose and limited-volume irradiation.

Keywords : Pineal Germinoma, Pineal Gland Tumor, CNS Germ Cell Tumors, Chemotherapy, Radiotherapy.

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Central nervous system germ cell tumors are rare tumors, most often located in the pineal region. This study aims to conduct a retrospective analysis of a series of patients treated for germinoma of the pineal gland.  Materials and Methods In 2020, six consecutive patients were treated for pineal gland germinoma at the National Oncology Institute in Rabat, Morocco. The diagnosis was confirmed histologically through stereotactic biopsy in five patients, while one patient was diagnosed based on biological (alpha-fetoprotein [AFP] and beta-human chorionic gonadotropin [B-HCG] levels), radiological, and therapeutic criteria. The median age was 22.4 years (range: 13–29 years). All patients received a combination of chemotherapy with four cycles of cisplatin and etoposide, followed by focal irradiation at 40 Gy (24 Gy to the ventricular system with a 16 Gy boost on the tumor residue).  Results and Statistical Analysis Five patients achieved complete remission, and one patient showed a partial response (74% reduction in pineal mass volume). All patients were alive without local recurrence after a median follow-up of 26 months.  Conclusion Pineal gland germ cell tumors have an excellent prognosis due to their radiosensitivity and chemosensitivity. Current treatment for pineal germinoma includes initial chemotherapy followed by limited-dose and limited-volume irradiation.

Keywords : Pineal Germinoma, Pineal Gland Tumor, CNS Germ Cell Tumors, Chemotherapy, Radiotherapy.

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