Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience

Frontiers in Oncology

Oncology

Rachid Abbas¹  Giovanna Stefania Colafati²  Eleonora Piccirilli²  Maristella Toniutti³  Andrea De Salvo⁴  Angela Mastronuzzi⁴  Giacomina Megaro⁴  Valentina Di Ruscio⁴  Giulia Albino⁴  Antonella Cacchione⁴  Maria Antonietta De Ioris⁴  Giada Del Baldo⁵  Stefano Lorentini⁶  Andrea Carai⁷  Sabrina Rossi⁸  Sabina Vennarini⁹ 

[1] CESP, INSERM, Université Paris Sud, Villejuif, France;Department of Diagnostic Imaging Oncological Neuroradiology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy;Department of Neuroscience, Imaging and Clinical Sciences, University of Chieti, Chieti, Italy;Department of Medicine DAME-Division of Pediatrics, University of Udine, Udine, Italy;Department of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy;Department of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy;Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy;Medical Physics Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy;Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy;Pathology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy;Pediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;

关键词: CNS germ cell tumors;    chemotherapy;    protontherapy;    outcome;    side effects;    pediatric brain tumors;   

DOI  :  10.3389/fonc.2023.1259403

 received in 2023-07-15, accepted in 2023-08-30,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundGerm cell tumors (GCT) account for a minority of central nervous system (CNS) malignancies, highly prevalent in adolescents and young adults. Despite their aggressive biological behavior, prognosis is excellent in most cases with risk stratified treatment, consisting in a combination of chemotherapy and radiotherapy. Whole ventricular irradiation (WVI) and craniospinal irradiation, the treatment of choice for localized and metastatic disease, pose significant risk of collateral effects, therefore proton beam radiation (PBT) has been recently proposed for its steep dose fallout.Materials and methodsWe report our experience in a consecutive series of 17 patients treated for CNS GCT at our Institution from 2015 to 2021.ResultsMost frequent lesion location were sellar/suprasellar (35%) and bifocal germinoma (35%), followed by pineal (18%) and thalamic (12%). Two patients (12%), had evidence of disseminated disease at the time of diagnosis. At the latest follow-up all but one patient showed complete response to treatment. The only relapse was successfully rescued by additional chemotherapy and PBT. PBT was well tolerated in all cases. No visual, neurological or endocrinological worsening was documented during and after treatment. Neuropsychological evaluation demonstrated preservation of cognitive performance after PBT treatment.ConclusionsOur data, albeit preliminary, strongly support the favourable therapeutic profile of PBT for the treatment of CNS germ cell tumors.

【 授权许可】

Unknown   
Copyright © 2023 Del Baldo, Vennarini, Toniutti, Abbas, Lorentini, Piccirilli, Cacchione, Megaro, Di Ruscio, De Ioris, De Salvo, Albino, Rossi, Colafati, Carai and Mastronuzzi