ACNS1123: response-based reduced-dose whole-ventricular radiotherapy for localised germinoma
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.
Overview
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.
- Three-year progression-free survival 94.5 percent with 18 Gy whole-ventricular irradiation after complete response.
- Overall survival 100 percent.
Response-adapted, reduced-dose whole-ventricular radiotherapy after chemotherapy is now a standard for localised germinoma in North American protocols.
- Single-arm trial; late neurocognitive outcomes are still being followed.
- The non-germinomatous stratum of the same trial had a different, less favourable result.
Similar pages
not linked directly; found by shared links- Key paperSIOP CNS GCT 96: outcomes for children and adults with intracranial germinoma treated with radiotherapy alone or chemotherapy plus reduced radiotherapy
Shares Neuro-Oncology, Central nervous system germ cell tumours (germinoma and non-germinomatous).
- Key paperThe 2021 WHO classification of tumours of the central nervous system: a summary
Shares Neuro-Oncology, Central nervous system germ cell tumours (germinoma and non-germinomatous).