Evaluation of Multımodality Imagıng For Management of Recurrent Intracranial Nongermınomatous Germ Cell Tumors (NGGCT) With Precise Radıatıon Therapy (Rt): An Origınal Article

Objective: Nongerminomatous germ cell tumor (NGGCT) may be considered as a distinct entity partly due to differential response to treatment especially in the central nervous system (CNS) and other extragonadal localizations.Initial diagnosis for NGGCT is at younger ages compared to germinoma, and overall survival rates for NGGCT is typically poorer given the resistance to administered therapies.Management of NGGCT warrants multidisciplinary input from medical oncology, surgery, and radiation oncology departments.Localized field radiotherapy, whole ventricle radiotherapy, whole brain irradiation, and craniospinal radiotherapy with local boost may be utilized alone or in combination with respect to patient, disease, and tumor characteristics.Despite aggressive management, intracranial recurrences may occur.In this original research article, we assess multimodality imaging for management of recurrent intracranial NGGCT with precise radiotherapy. Materials and Methods:Patients referred to Department of Radiation Oncology, Gulhane Medical Faculty, University of Health Sciences for radiotherapeutic management of recurrent intracranial NGGCT were assessed to investigate whether multimodality imaging contributes to target and treatment volume definition, interobserver and intraobserver variations.A comparative evaluation and analysis was performed for radiaotherapy target definitions based on computed tomography (CT) simulation images only or by integration of Magnetic Resonance Imaging (MRI) in the radiation treatment planning procedure.Results: As a result of this study, we have found that ground truth target volume was identical with CT-MR registration based imaging for radiotherapeutic management of patients with recurrent intracranial NGGCT.Conclusion: This study supports the utilization of multimodality imaging for improved target definition for recurrent intracranial NGGCT.Clearly, there may be the requirement for additional supporting data from future studies.