The comparison of treatment outcomes between combined chemotherapy-radiation therapy (Chemo-RT) and radiation therapy alone (RT) in intracranial germ cell tumor in adolescent and young adult patients (AYA)

Background The incidence of Intracranial germ cell tumor(iGCT) in adolescents and young adults (AYA) is less common that in pediatric patients. However, the recurrent rate of iGCT in AYA (7.6%) is higher than children (2%). Because iGCT in AYA population are lacking randomized trials to standardize the treatment. Thus, the purpose of this study is to determine the practice patterns and outcomes of iGCT in AYA. Methods This is a single-center retrospective cohort study. Patients with IGCT aged 15 to 39 years were managed at Siriraj Hospital, Thailand from 2007 to 2019. The charts were reviewed and compared outcome between who received Chemo-RT and RT alone. Results The median follow-up time was 7.6 years. Eighty-four patients were included in this study: 60 germinomas, 24 NGGCT patients. In the case of NGGCT, the 5-year and 10-year EFS/OS were 100% and 100% in RT alone. In RT plus chemotherapy, the 5-year and 10-year EFS were 67.57% and 54.05%. The 5-year and 10-year OS were 68.44% and 68.44%. For germinoma, the 5-year and 10-year EFS were 95.83% and 76.87% in RT alone. The 5-year and 10-year OS were 95.83% and 86.40%. Whereas in RT plus chemotherapy, the 5-year and 10-year EFS were 73.33% and 69.63%. The 5-year and 10-year OS were 85.10% and 69.63%. Conclusions We report the outcomes with different approaches of patients in AYA with iGCT to our knowledge. In our series, the patient who received chemotherapy had no survival benefit and probably worsen survival in both NGCCT and pure germinoma.