# ACNS1123: response-based reduced-dose whole-ventricular radiotherapy for localised germinoma

Source: https://onco.cc/key-papers/paper-acns1123-germinoma-neuro-oncology-2022/  
OnCo record `paper-acns1123-germinoma-neuro-oncology-2022` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

In children with localised germinoma who responded completely to chemotherapy, lowering the whole-ventricular radiotherapy dose to 18 Gy kept cure rates above 90 percent, allowing less radiation to the developing brain.

## Summary

Children's Oncology Group phase 2 trial of 137 patients with localised germinoma treated with carboplatin and etoposide induction; complete responders received reduced-dose whole-ventricular irradiation (18 Gy) with a 12 Gy boost, while partial responders received 24 Gy plus boost.

Three-year progression-free survival was 94.5 percent in the reduced-dose group and overall survival 100 percent, with the trial meeting its goal of maintaining outcomes with less radiation.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: Neuro-Oncology
- Year: 2022
- DOI: 10.1093/neuonc/noab270
- Authors: Bartels U, Onar-Thomas A, Patel SK, et al.
- Findings: Three-year progression-free survival 94.5 percent with 18 Gy whole-ventricular irradiation after complete response.; Overall survival 100 percent.
- What it means: Response-adapted, reduced-dose whole-ventricular radiotherapy after chemotherapy is now a standard for localised germinoma in North American protocols.
- Caveats: Single-arm trial; late neurocognitive outcomes are still being followed.; The non-germinomatous stratum of the same trial had a different, less favourable result.

## Sources

- Neuro Oncol 2022: https://doi.org/10.1093/neuonc/noab270
- PubMed: https://pubmed.ncbi.nlm.nih.gov/34850169/

## Connected records

- cancers: [Central nervous system germ cell tumours (germinoma and non-germinomatous)](https://onco.cc/cancers/cns-germ-cell-tumours/)
- journals: [Neuro-Oncology](https://onco.cc/journals/neuro-oncology/)

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