EANO, SNO and Euracan consensus review on the current management and future development of intracranial germ cell tumors in adolescents and young adults.
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Authors
Frappaz, Didier
Dhall, Girish
Goldman, Stuart
Faure Conter, Cecile
Allen, Jeffrey
Kortmann, Rolf Dieter
Haas-Kogen, Daphne
Morana, Giovanni
Finlay, Jonathan
Nicholson, James C
Souweidane, Mark
Schönberger, Stefan
Vasiljevic, Alexandre
Robertson, Patricia
Alapetite, Claire
Lau, Chin C
Wen, Patrick
Schiff, David
Shaw, Dennis
Calaminus, Gabriele
Publication Date
2022-04-01Journal Title
Neuro Oncol
ISSN
1522-8517
Publisher
Oxford University Press (OUP)
Language
eng
Type
Article
This Version
AM
Metadata
Show full item recordCitation
Frappaz, D., Dhall, G., Murray, M., Goldman, S., Faure Conter, C., Allen, J., Kortmann, R. D., et al. (2022). EANO, SNO and Euracan consensus review on the current management and future development of intracranial germ cell tumors in adolescents and young adults.. Neuro Oncol https://doi.org/10.1093/neuonc/noab252
Abstract
The incidence of intracranial germ cell tumors (iGCT) is much lower in European and North American (E&NA) than in Asian population. However, E&NA cooperative groups have simultaneously developed with success treatment strategies with specific attention paid to long-term sequelae. Neurological sequelae may be reduced by establishing a diagnosis with an endoscopic biopsy and/or cerebrospinal fluid (CSF) and/or serum analysis, deferring the need to perform a radical surgery. Depending on markers and/or histological characteristics, patients are treated as either germinoma or non-germinomatous germ cell tumors (NGGCT). Metastatic disease is defined by a positive CSF cytology and/or distant drops in craniospinal MRI. The combination of surgery and/or chemotherapy and radiation therapy is tailored according to grouping and staging. With more than 90% 5-year event-free survival (EFS), localized germinomas can be managed without aggressive surgery, and benefit from chemotherapy followed by whole ventricular irradiation with local boost. Bifocal germinomas are treated as non-metastatic entities. Metastatic germinomas may be cured with craniospinal irradiation. With a 5-year EFS over 70%, NGGCT benefit from chemotherapy followed by delayed surgery in case of residual disease, and some form of radiotherapy. Future strategies will aim at decreasing long-term side effects while preserving high cure rates.
Keywords
Brain tumors, Germ Cell Tumor, Germinoma, Non-germinomatous germ cell tumor, adolescent and young adult
Embargo Lift Date
2022-11-01
Identifiers
External DOI: https://doi.org/10.1093/neuonc/noab252
This record's URL: https://www.repository.cam.ac.uk/handle/1810/330476
Rights
Attribution-NonCommercial 4.0 International
Licence URL: https://creativecommons.org/licenses/by-nc/4.0/
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