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Targeted and Selective Treatment of Pluripotent Stem Cell-derived Teratomas Using External Beam Radiation in a Small-animal Model
Published on: February 17, 2019
Treatment and outcomes of primary intracranial teratoma
Yun-Ho Lee1, Eun Kyung Park, Young Seok Park
1Department of Neurosurgery, Severance Children's Hospital, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, South Korea.
Purpose:
Until recently, postoperative adjuvant treatment for intracranial teratomas has remained controversial because of the rarity of the tumors and the heterogeneity of histologic types. To define optimal therapy modalities, we retrospectively analyzed the treatment of patients with intracranial teratomas.
Methods:
Between 1979 and 2007, 31 patients with intracranial teratomas were treated at our institution. The median age of the 31 patients was 14.8 years. The median follow-up time was 72.7 months (range 11 approximately 291 months). Perioperative radiochemotherapy was done in 19 patients. Proper chemotherapy regimens were followed, such as PE (cisplatin and VP-16), PVB (cisplatin, VP-16, and bleomycin), ICE (carboplatin, VP-16, and ifosfamide), and NGGCT (etoposide, carboplatin, bleomycin, and cyclophosphamide with mesna).
Results:
Eight patients experienced recurrence, and a second operation was carried out in six patients. Fifteen patients survived for more than 5 years without recurrence, irrespective of having received adjuvant therapies. The 5-year survival rate of the 31 patients was 74%.
Conclusion:
Treatment of intracranial teratomas is very difficult because of the heterogeneity of the tumor cells from totipotent origins. Accurate histological diagnosis of teratoma subtypes is the most important factor for adequate treatment, and proper therapeutic protocols are needed to cure teratomas.
Insights
Optimal treatment for intracranial teratomas remains challenging due to tumor rarity and heterogeneity. Accurate diagnosis and tailored therapeutic protocols are crucial for improving survival rates in patients with these rare brain tumors.
Area of Science:
- Neuro-oncology
- Pediatric oncology
- Surgical oncology
Background:
- Intracranial teratomas are rare tumors with diverse histological types, making postoperative adjuvant treatment controversial.
- Optimal therapeutic strategies for intracranial teratomas have been historically debated due to tumor rarity and heterogeneity.
Purpose of the Study:
- To retrospectively analyze treatment modalities for intracranial teratomas.
- To define optimal therapy for patients diagnosed with intracranial teratomas.
Main Methods:
- Retrospective analysis of 31 patients treated between 1979 and 2007.
- Patients received perioperative radiochemotherapy, including regimens like PE, PVB, ICE, and NGGCT.
- Median follow-up was 72.7 months.
Main Results:
- The 5-year survival rate for all patients was 74%.
- Fifteen patients survived over 5 years without recurrence, regardless of adjuvant therapy.
- Eight patients experienced recurrence, with six undergoing a second operation.
Conclusions:
- Accurate histological subtyping of teratomas is critical for effective treatment planning.
- Developing standardized therapeutic protocols is essential for improving outcomes in intracranial teratoma patients.
- The heterogeneity of teratoma cells necessitates precise diagnostic and treatment approaches.
