Pathologically-proven intracranial germinoma treated with radiation therapy

Area of Science:

• Neuro-oncology
• Radiation Oncology
• Pathology

Background:

• Intracranial germinomas are a significant type of brain tumor.
• Accurate pathological confirmation is crucial for appropriate treatment planning.

Purpose of the Study:

• To determine the percentage of intracranial germinomas pathologically confirmed before radiotherapy.
• To evaluate the impact of radiation field selection on patient outcomes.

Main Methods:

• Retrospective multi-institutional study of 110 patients over 16 years.
• Analysis of pathological confirmation rates and radiotherapy field choices (craniospinal, whole-brain, local).
• Computed tomography (CT) scan data reviewed for all patients.

Main Results:

• Only 37% of patients had pathological confirmation before radiotherapy.
• Confirmation rates increased over the study period (26% to 53%).
• 10-year relapse-free survival rates varied significantly by radiation field: 90% (craniospinal), 76% (whole-brain), and 22% (local without ventricle inclusion).

Conclusions:

• Pathological confirmation for intracranial germinomas is underutilized, even in the CT scan era.
• Limited local irradiation without ventricle inclusion is associated with significantly worse outcomes.
• Standardized pathological confirmation and appropriate radiotherapy field selection are essential for improving intracranial germinoma treatment.