High-dose chemotherapy with autologous stem cell transplantation spares re-irradiation for recurrent intracranial germinoma

Pediatr Blood Cancer. 2018 Aug;65(8):e27104. doi: 10.1002/pbc.27104. Epub 2018 Apr 25.

Abstract

The clinical outcome of high-dose chemotherapy (HDC) with autologous stem cell transplantation was retrospectively analyzed in six patients with recurrent intracranial germinoma. Prior to HDC, all patients achieved complete remission after platinum and ifosfamide-based chemotherapy. A melphalan-based conditioning regimen was administered in either a single cycle or multiple sequential cycles. Five of the six patients are alive and free from disease, with a median survival of 65 months, among which four patients avoided re-irradiation. In a significant proportion of patients, recurrent intracranial germinoma is curable by HDC without re-irradiation, provided that the disease remains sensitive to salvage chemotherapy.

Keywords: high-dose chemotherapy; intracranial germinoma; melphalan; re-irradiation; recurrence.

MeSH terms

  • Adolescent
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Child
  • Combined Modality Therapy / methods
  • Female
  • Germinoma / pathology
  • Germinoma / therapy*
  • Humans
  • Male
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / therapy*
  • Peripheral Blood Stem Cell Transplantation / methods*
  • Re-Irradiation
  • Retrospective Studies
  • Salvage Therapy / methods
  • Transplantation, Autologous
  • Young Adult