{"entity":{"id":"paper-acns1123-germinoma-neuro-oncology-2022","kind":"paper","name":"ACNS1123: response-based reduced-dose whole-ventricular radiotherapy for localised germinoma","aka":[],"tldr":"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.\n\nThree-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.","asOf":"2026-09-17","links":[{"label":"Neuro Oncol 2022","url":"https://doi.org/10.1093/neuonc/noab270"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/34850169/"}],"tags":[],"related":[],"cancers":["cns-germ-cell-tumours"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["neuro-oncology"],"dependsOn":[],"notes":[],"journal":"Neuro-Oncology","year":2022,"doi":"10.1093/neuonc/noab270","pmid":"34850169","authors":"Bartels U, Onar-Thomas A, Patel SK, et al.","paperType":"observational","findings":["Three-year progression-free survival 94.5 percent with 18 Gy whole-ventricular irradiation after complete response.","Overall survival 100 percent."],"whatItMeans":"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."],"changedPractice":true,"participants":137},"route":"/key-papers/paper-acns1123-germinoma-neuro-oncology-2022/","neighbours":{"cancer":[{"id":"cns-germ-cell-tumours","kind":"cancer","name":"Central nervous system germ cell tumours (germinoma and non-germinomatous)","route":"/cancers/cns-germ-cell-tumours/"}],"journal":[{"id":"neuro-oncology","kind":"journal","name":"Neuro-Oncology","route":"/journals/neuro-oncology/"}]}}