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Intracranial germ-cell tumours--treatment results and residuals
1Departments of Paediatrics and Neurosurgery, University Hospital Hamburg-Eppendorf, Germany.
Insights
Long-term survival for children treated for intracranial germ-cell tumors is high, especially for germinomas. Most survivors experience good quality of life with rare severe neurological deficits.
Area of Science:
- Pediatric Oncology
- Neuro-oncology
- Child Development
Background:
- Limited data exists on long-term outcomes for children treated for intracranial germ-cell tumors.
- Intracranial germ-cell tumors represent a significant challenge in pediatric neuro-oncology.
Purpose of the Study:
- To evaluate treatment outcomes, long-term residuals, and quality of life in children with intracranial germ-cell tumors.
- To provide insights into the developmental trajectory of pediatric patients post-treatment.
Main Methods:
- Retrospective analysis of 26 children treated between 1981 and 1992.
- Assessment of event-free survival, neurological function, neuro-endocrine status, neuropsychological function, educational progress, and self-assessed quality of life.
Main Results:
- Long-term event-free survival was 88% for germinomas and 43% for malignant teratomas.
- 58% had no significant neurological deficits; 6 patients (11.5%) experienced neuro-endocrine dysfunction, successfully managed with therapy.
- 53% had no or mild neuropsychological disturbances, with information processing speed being the most affected function. 69% continued education at their previous level.
Conclusions:
- Surgical removal and radiation therapy yield an 88% long-term survival for intracranial germinomas, with rare severe residuals and good quality of life.
- Malignant teratomas show less favorable outcomes with current treatment regimens, including chemotherapy.
- Despite craniospinal axis radiation, a good quality of life is achievable for most survivors of intracranial germinomas.
Unlabelled:
There is only sparse information about the development of children after successful treatment for intracranial germ-cell tumours. Between January 1981 and June 1992, 26 children with intracranial germ-cell tumours were treated in the University Hospital Hamburg-Eppendorf. We report on treatment results, long standing residuals and the "quality of life" of these patients. The long-term event-free survival was 88% for the germinomas and 43% for the malignant teratomas. Of the patients 58% had no relevant functional neurological deficits and 37% had mild impairment. Only 1 patient with metastatic disease was severely handicapped. Six patients showed neuro-endocrine dysfunction. All of them had suprasellar/hypothalamic lesions and all received successful substitution therapy. As to neuropsychological functions, 53% of the patients had no or only mild disturbances. The most affected function was speed of information processing. Of the children 69% were able to proceed with their education at the same level as before therapy. The overall self-assessment revealed good results in 75% of the patients.
Conclusion:
After surgical removal and radiation therapy long-term survival of intracranial germinomas amounts to 88%. Despite craniospinal axis radiation severe residuals are rare and a good quality of life is common. In malignant teratomas treatment regimens including chemotherapy are much less successful.