Skip to main content
Erschienen in: Current Oncology Reports 7/2014

01.07.2014 | Pediatric Oncology (S Epelman, Section Editor)

Advances in the Management of Central Nervous System Germ Cell Tumors

verfasst von: Nathan E. Millard, Ira J. Dunkel

Erschienen in: Current Oncology Reports | Ausgabe 7/2014

Einloggen, um Zugang zu erhalten

Abstract

Intracranial germ cell tumors represent a relatively small portion of pediatric central nervous system tumors, with a reported incidence ranging from 3.6% in North America to 15.3% in parts of Asia. They are known to arise in midline locations, most frequently the pineal gland and suprasellar regions, and affect males twice to three times more frequently than females, especially in the case of pineal-region tumors. The median age of diagnosis is 10–12 years. The treatment of intracranial germ cells tumors is complicated by their relative rarity, histologic heterogeneity, and a lack of widespread consensus on their optimal management. Despite these challenges, important progress continues to be made, with a move toward multicenter and international collaborative efforts that offer potential for clinical advancements. This review focuses on recent developments in the management of intracranial germ cell tumors, including updates in diagnosis, surveillance, biology, treatment, and outcomes.
Literatur
1.
Zurück zum Zitat Echevarría ME, Fangusaro J, Goldman S. Pediatric central nervous system germ cell tumors: a review. Oncologist. 2008;13:690.PubMedCrossRef Echevarría ME, Fangusaro J, Goldman S. Pediatric central nervous system germ cell tumors: a review. Oncologist. 2008;13:690.PubMedCrossRef
2.
Zurück zum Zitat Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg. 1985;63:155.PubMedCrossRef Jennings MT, Gelman R, Hochberg F. Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg. 1985;63:155.PubMedCrossRef
3.
Zurück zum Zitat Hoffman HJ, Otsubo H, Hendrick EB, et al. Intracranial germ-cell tumors in children. J Neurosurg. 1991;74:545.PubMedCrossRef Hoffman HJ, Otsubo H, Hendrick EB, et al. Intracranial germ-cell tumors in children. J Neurosurg. 1991;74:545.PubMedCrossRef
4.
Zurück zum Zitat Matsutani M, Sano K, Takakura K, et al. Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg. 1997;86:446.PubMedCrossRef Matsutani M, Sano K, Takakura K, et al. Primary intracranial germ cell tumors: a clinical analysis of 153 histologically verified cases. J Neurosurg. 1997;86:446.PubMedCrossRef
5.•
Zurück zum Zitat Murray MJ, Horan G, Lowis S, Nicholson JC. Highlights from the Third International Central Nervous System Germ Cell Tumour Symposium: laying the foundations for future consensus. Ecancermedicalscience. 2013;7:333. This is a summary of the topics of discussion at a symposium of 117 delegates from 25 countries highlighting progress in the treatment of CNS germ cell tumors as well as areas of agreement and controversy.PubMedCentralPubMed Murray MJ, Horan G, Lowis S, Nicholson JC. Highlights from the Third International Central Nervous System Germ Cell Tumour Symposium: laying the foundations for future consensus. Ecancermedicalscience. 2013;7:333. This is a summary of the topics of discussion at a symposium of 117 delegates from 25 countries highlighting progress in the treatment of CNS germ cell tumors as well as areas of agreement and controversy.PubMedCentralPubMed
6.
Zurück zum Zitat Bamberg M, Kortmann R, Calaminus G, et al. Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89. J Clin Oncol. 1999;17(8):2585.PubMed Bamberg M, Kortmann R, Calaminus G, et al. Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89. J Clin Oncol. 1999;17(8):2585.PubMed
7.
Zurück zum Zitat Alapetite C, Brisse H, Patte C, et al. Pattern of relapse and outcome of non-metastatic germinoma patients treated with chemotherapy and limited field radiation: the SFOP experience. Neuro Oncol. 2010;12(12):1318.PubMedCentralPubMed Alapetite C, Brisse H, Patte C, et al. Pattern of relapse and outcome of non-metastatic germinoma patients treated with chemotherapy and limited field radiation: the SFOP experience. Neuro Oncol. 2010;12(12):1318.PubMedCentralPubMed
8.
Zurück zum Zitat Bouffet E, Baranzelli MC, Patte C, et al. Combined treatment modality for intracranial germinomas: results of a multicentre SFOP experience. Br J Cancer. 1999;79(7/8):1199.PubMedCentralPubMedCrossRef Bouffet E, Baranzelli MC, Patte C, et al. Combined treatment modality for intracranial germinomas: results of a multicentre SFOP experience. Br J Cancer. 1999;79(7/8):1199.PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Da Silva NS, Cappellano AM, Diez B, et al. Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell zumor study. Pediatr Blood Cancer. 2010;54:377.PubMedCrossRef Da Silva NS, Cappellano AM, Diez B, et al. Primary chemotherapy for intracranial germ cell tumors: results of the third international CNS germ cell zumor study. Pediatr Blood Cancer. 2010;54:377.PubMedCrossRef
10.
Zurück zum Zitat Souweidane MM, Krieger MD, Weiner HL, Finlay JL. Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors. J Neurosurg Pediatr. 2010;6:125.PubMedCrossRef Souweidane MM, Krieger MD, Weiner HL, Finlay JL. Surgical management of primary central nervous system germ cell tumors: proceedings from the Second International Symposium on Central Nervous System Germ Cell Tumors. J Neurosurg Pediatr. 2010;6:125.PubMedCrossRef
11.••
Zurück zum Zitat Calaminus G, Kortmann R, Worch J, et al. SIOP CNS GCT 96: final report of outcome of a prospective, multinational nonrandomized trial for children and adults with intracranial germinoma, comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease. Neuro Oncol. 2013;15(6):788. This is an international multicenter trial demonstrating efficacy of two distinct regimens for treatment of CNS germinoma.PubMedCentralPubMedCrossRef Calaminus G, Kortmann R, Worch J, et al. SIOP CNS GCT 96: final report of outcome of a prospective, multinational nonrandomized trial for children and adults with intracranial germinoma, comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease. Neuro Oncol. 2013;15(6):788. This is an international multicenter trial demonstrating efficacy of two distinct regimens for treatment of CNS germinoma.PubMedCentralPubMedCrossRef
12.
Zurück zum Zitat Bouffet E. The role of myeloablative chemotherapy with autologous hematopoietic cell rescue in central nervous system germ cell tumors. Pediatr Blood Cancer. 2010;54:644.PubMedCrossRef Bouffet E. The role of myeloablative chemotherapy with autologous hematopoietic cell rescue in central nervous system germ cell tumors. Pediatr Blood Cancer. 2010;54:644.PubMedCrossRef
13.
Zurück zum Zitat Sethi RV, Marino R, Niemierko A, et al. Delayed diagnosis in children with intracranial germ cell tumors. J Pediatr. 2013;163:1448.PubMedCrossRef Sethi RV, Marino R, Niemierko A, et al. Delayed diagnosis in children with intracranial germ cell tumors. J Pediatr. 2013;163:1448.PubMedCrossRef
14.
Zurück zum Zitat Weksberg DC, Shibamoto Y, Paulino AC. Bifocal intracranial germinoma: a retrospective analysis of treatment outcomes in 20 patients and review of the literature. Int J Radiat Oncol Biol Phys. 2012;82(4):1341.PubMedCrossRef Weksberg DC, Shibamoto Y, Paulino AC. Bifocal intracranial germinoma: a retrospective analysis of treatment outcomes in 20 patients and review of the literature. Int J Radiat Oncol Biol Phys. 2012;82(4):1341.PubMedCrossRef
15.
Zurück zum Zitat Lafay-Cousin L, Millar B, Mabbott D, et al. Limited-field radiation for bifocal germinoma. Int J Radiat Oncol Biol Phys. 2006;65(2):486.PubMedCrossRef Lafay-Cousin L, Millar B, Mabbott D, et al. Limited-field radiation for bifocal germinoma. Int J Radiat Oncol Biol Phys. 2006;65(2):486.PubMedCrossRef
16.
Zurück zum Zitat Phi JH, Kim S, Lee J, et al. The enigma of bifocal germ cell tumors in the suprasellar and pineal regions: synchronous lesions or metastasis? J Neurosurg Pediatr. 2013;11:107.PubMedCrossRef Phi JH, Kim S, Lee J, et al. The enigma of bifocal germ cell tumors in the suprasellar and pineal regions: synchronous lesions or metastasis? J Neurosurg Pediatr. 2013;11:107.PubMedCrossRef
18.
Zurück zum Zitat Aizer AA, Sethi RV, Hedley-Whyte ET, et al. Bifocal intracranial tumors of nongerminoatous germ cell etiology: diagnostic and therapeutic implications. Neuro Oncol. 2013;15(7):955.PubMedCentralPubMedCrossRef Aizer AA, Sethi RV, Hedley-Whyte ET, et al. Bifocal intracranial tumors of nongerminoatous germ cell etiology: diagnostic and therapeutic implications. Neuro Oncol. 2013;15(7):955.PubMedCentralPubMedCrossRef
19.
Zurück zum Zitat Martinez S, Khakoo Y, Gilheeney S, et al. Marker (+) CNS germ cell tumors in remission: are surveillance MRI scans necessary? Pediatr Blood Cancer. 2013;61(5):853.PubMedCrossRef Martinez S, Khakoo Y, Gilheeney S, et al. Marker (+) CNS germ cell tumors in remission: are surveillance MRI scans necessary? Pediatr Blood Cancer. 2013;61(5):853.PubMedCrossRef
20.
Zurück zum Zitat Legault G, Allen J. Potential role of ventricular tumor markers in CNS germ cell tumors. Pediatr Blood Cancer. 2013;60:1647.PubMedCrossRef Legault G, Allen J. Potential role of ventricular tumor markers in CNS germ cell tumors. Pediatr Blood Cancer. 2013;60:1647.PubMedCrossRef
21.
Zurück zum Zitat Fukushima S, Otsuka A, Suzuki T, et al. Mutually exclusive mutations of KIT and RAS are associated with KIT mRNA expression and chromosomal instability in primary intracranial pure germinomas. Acta Neuropathol. 2014. doi:10.1007/s00401-014-1247-5.PubMed Fukushima S, Otsuka A, Suzuki T, et al. Mutually exclusive mutations of KIT and RAS are associated with KIT mRNA expression and chromosomal instability in primary intracranial pure germinomas. Acta Neuropathol. 2014. doi:10.​1007/​s00401-014-1247-5.PubMed
22.
Zurück zum Zitat Osorio DS, Finlay JL, Dhall G, et al. Feasibility of dasatinib in children and adolescents with new or recurrent central nervous system germinoma. Pediatr Blood Cancer. 2013;60:E100.PubMedCrossRef Osorio DS, Finlay JL, Dhall G, et al. Feasibility of dasatinib in children and adolescents with new or recurrent central nervous system germinoma. Pediatr Blood Cancer. 2013;60:E100.PubMedCrossRef
24.•
Zurück zum Zitat Terashima K, Yu A, Chow WT, et al. Genome-wide analysis of DNA copy number alterations and loss of heterozygosity in intracranial germ cell tumors. Pediatr Blood Cancer. 2014;61:593. This is the largest investigation to date of genomic alterations in CNS germ cell tumors.PubMedCrossRef Terashima K, Yu A, Chow WT, et al. Genome-wide analysis of DNA copy number alterations and loss of heterozygosity in intracranial germ cell tumors. Pediatr Blood Cancer. 2014;61:593. This is the largest investigation to date of genomic alterations in CNS germ cell tumors.PubMedCrossRef
24.
Zurück zum Zitat Ogino H, Shibamoto Y, Takanaka T, et al. CNS germinoma with elevated serum human chorionic gonadotropin level: clinical characteristics and treatment outcome. Int J Radiat Oncol Biol Phys. 2005;62(3):803.PubMedCrossRef Ogino H, Shibamoto Y, Takanaka T, et al. CNS germinoma with elevated serum human chorionic gonadotropin level: clinical characteristics and treatment outcome. Int J Radiat Oncol Biol Phys. 2005;62(3):803.PubMedCrossRef
25.
Zurück zum Zitat Shibamoto Y, Takahashi M, Sasai K. Prognosis of intracranial germinoma with syncytiotrophoblastic giant cells treated by radiation therapy. Int J Radiat Oncol Biol Phys. 1997;37(3):505.PubMedCrossRef Shibamoto Y, Takahashi M, Sasai K. Prognosis of intracranial germinoma with syncytiotrophoblastic giant cells treated by radiation therapy. Int J Radiat Oncol Biol Phys. 1997;37(3):505.PubMedCrossRef
26.
Zurück zum Zitat Lim DH, Yoo KH, Lee NH, et al. Intensive chemotherapy followed by reduced-dose radiotherapy for biopsy-proven CNS germinoma with elevated beta-human chorionic gonadotropin. J Neurooncol. 2014;117(2):279.CrossRef Lim DH, Yoo KH, Lee NH, et al. Intensive chemotherapy followed by reduced-dose radiotherapy for biopsy-proven CNS germinoma with elevated beta-human chorionic gonadotropin. J Neurooncol. 2014;117(2):279.CrossRef
27.
Zurück zum Zitat Baek HJ, Park HJ, Sung KW, et al. Myeloablative chemotherapy and autologous stem cell transplantation in patients with relapsed or progressed central nervous system germ cell tumors: results of Korean Society of Pediatric Neuro-Oncology (KSPNO) S-053 study. J Neurooncol. 2013;114:329.PubMedCrossRef Baek HJ, Park HJ, Sung KW, et al. Myeloablative chemotherapy and autologous stem cell transplantation in patients with relapsed or progressed central nervous system germ cell tumors: results of Korean Society of Pediatric Neuro-Oncology (KSPNO) S-053 study. J Neurooncol. 2013;114:329.PubMedCrossRef
28.
Zurück zum Zitat Liang S, Yang T, Chen Y, et al. Neuropsychological functions and quality of life in survived patients with intracranial germ cell tumors after treatment. Neuro Oncol. 2013;15(11):1543.PubMedCentralPubMedCrossRef Liang S, Yang T, Chen Y, et al. Neuropsychological functions and quality of life in survived patients with intracranial germ cell tumors after treatment. Neuro Oncol. 2013;15(11):1543.PubMedCentralPubMedCrossRef
29.
Zurück zum Zitat Jinguji S, Yoshimura J, Nishiyama K, et al. Factors affected functional outcomes in long-term survivors of intracranial germinomas: a 20-year experience in a single institution. J Neurosurg Pediatr. 2013;11:454.PubMedCrossRef Jinguji S, Yoshimura J, Nishiyama K, et al. Factors affected functional outcomes in long-term survivors of intracranial germinomas: a 20-year experience in a single institution. J Neurosurg Pediatr. 2013;11:454.PubMedCrossRef
Metadaten
Titel
Advances in the Management of Central Nervous System Germ Cell Tumors
verfasst von
Nathan E. Millard
Ira J. Dunkel
Publikationsdatum
01.07.2014
Verlag
Springer US
Erschienen in
Current Oncology Reports / Ausgabe 7/2014
Print ISSN: 1523-3790
Elektronische ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-014-0393-1

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.