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.
References :
- Echevarría ME, Fangusaro J, Goldman S. Pediatric central nervous system germ cell tumors: a review. Oncologist. 2008;13(6):690-699.
- Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: Natural history and pathogenesis. J Neurosurg. 1985;63(2):155-167.
- Matsutani M, Sano K, Takakura K, et al. Primary intracranial germ cell tumors: A clinical analysis of 153 histologically verified cases. J Neurosurg. 1997;86(3):446-455.
- Bamberg M, Kortmann RD, Calaminus G, et al. Radiation therapy for intracranial germinoma: Results of the German Cooperative Trial MAKEI 83/86/89. J Clin Oncol. 1999;17(8):2585-2592.
- Calaminus G, Bamberg M, Harms D, et al. Impact of chemotherapy on the treatment of intracranial germ cell tumors: Long-term results of the German cooperative protocols. J Clin Oncol. 1997;15(4):1609-1618.
- Lo AC, Hodgson D, Dang J, et al. Intracranial germ cell tumors in adolescents and young adults: Long-term follow-up and outcomes. Pediatr Blood Cancer. 2019;66(7)
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- Echevarría M, Fangusaro J. Germ cell tumors of the central nervous system: Advances in treatment and biology. J Clin Oncol. 2008;26(15):2589–2593.
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- Louis DN, Ohgaki H, Wiestler OD, et al., eds. WHO Classification of Tumours of the Central Nervous System. IARC; 2007.
- Robertson PL, Da Ros V, Allen JC, et al. The role of tumor markers in predicting response to therapy and survival in intracranial germ cell tumors. Pediatr Neurosurg. 1997;27(4):208–214.
- Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: Natural history and pathogenesis. J Neurosurg. 1985;63(2):155–167.
- Calaminus G, Bamberg M, Baranzelli MC, et al. Intracranial germ cell tumors: A comprehensive update of clinical trials. Lancet Oncol. 2008;9(9):835–844.
- Echevarría M, Fangusaro J, Goldman S. Pediatric central nervous system germ cell tumors: A review. Oncologist. 2008;13(6):690–699.
- Fangusaro J, Finlay JL. Current management of patients with CNS germ cell tumors. Expert Rev Anticancer Ther. 2008;8(10):1559–1568.
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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.