Abstract 771P
Background
Primary Central Nervous system Germ cell tumors (CNS GCT) are rare neoplasms that are divided into germminoma and non-germinomatous germ cell tumors (NGGCT). CNS GCTs are known to be radiosensitive and are highly treatable. However, to reduce the dose of radiation,. Various approaches to neoadjuvant chemotherapy followed by response-based reduced-dose radiotherapy have been attempted. Nevertheless, as a result of insufficient cases, a definitive approach has not yet been established. This paper aims to review and evaluate current outcomes of different chemotherapy followed by reduced dose radiotherapy regimens given to Primary CNS germ cell tumors.
Methods
Studies were collected from Pubmed, PMC, and ScienceDirect, using combinations of keywords “Primary Central Nervous System” or “Primary Intracranial” AND “nongerminomatous germ cell tumor” OR “Germinoma” and “Chemotherapy” AND “Radiotherapy”. The included studies showed data of treatment outcome and adverse effects of chemotherapy followed by reduced dose radiotherapy in CNS GCT patients in the past 10 years. The Newcastle Ottawa Scale was used to assess the quality of observational studies, while the JADAD Scale was used for randomized controlled trials studies and the MINORS tool for non-randomized trials.
Results
A total of 13 Cohort studies, 1 Randomized controlled trial (RCT) and 1 single-arm clinical trial consisting of 1567 cases of primary CNS GCT were included. The included studies had moderate to good qualities based on the quality assessments. Most of the studies showed the effectiveness of carboplatin/etoposide with or without ifosfamide induction, followed by a reduced dose of radiotherapy as low as 12.6 Gy at the primary site with a high rate of PFS and OS. Adverse effects most frequently encountered were Hematological toxicities, electrolyte imbalance and ototoxicity such as anemia, leukopenia, thrombocytopenia, hyper- or hyponatremia and sensorineural hearing loss.
Conclusions
In Conclusion, chemotherapy induction followed by radiotherapy collectively exhibit positive results for primary NCS GST. Nonetheless, it is essential to conduct further research, especially in a randomized control trial manner.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.