Abstract Background Intracranial germ cell tumors (iGCT) represent 3–5% of pediatric brain tumors. Their high sensitivity to chemotherapy and radiotherapy led to excellent survival in high-income countries. However, in low-resource settings, they remain associated with high mortality and long-term sequelae. There is limited information on GCT specific resources and outcomes in Latin America. Methods A cross-sectional survey was conducted in Latin-American, collecting data on infrastructure, diagnostics, treatment protocols, and follow-up practices. Results Thirty-five centers responded (60% public). Although 80% reported epidemiological registries, only 37.1% had complete databases. Tumors were predominantly suprasellar. Nearly half of centers (57.1%) lacked a neuro-oncologist; most had access to pediatric subspecialists; endocrinologists (91.4%), neurologists (91.4%), ophthalmologists (71.4%), and neurosurgeons (77.1%). Serum and CSF tumor markers were available at 60%, while 27.8% lacked defined cutoff values, and 22.9% did not routinely assess CSF. Pathology was available in 91.4%, and molecular studies in 60%. Radiotherapy is available in 45.7% with delays 2 weeks (51.4%). Diagnosis without biopsy was established in cases with positive tumor markers (91.4%) or bifocal disease (41.7%). Neoadjuvant chemotherapy was administered in 97%. Germinoma treatment predominantly was carboplatin/etoposide (57.1%), while NGGCT regimens were heterogeneous carboplatin/etoposide alternating with ciclofosfamide/etoposide (34.3%) or with ifosfamide/etoposide (17.3%) PEI (17,3%), BEP, and ICE (11.4%). Whole-ventricular irradiation was administered for localized germinoma and CSI for metastatic disease, while the radiotherapy field in NGGCT metastatic was 88.6% CSI and 8.6% focal. Relapse treatment included ICE (58.8%), high-dose chemotherapy plus transplant (44.1%), and GemPOx (32.4%). Long-term follow-up ≥10 years was reported by 48,6% of centers, while survivorship clinics were inconsistently available despite broad access to palliative care (85.7%). Conclusions Substantial heterogeneity persists in resources and management of pediatric iGCTs across Latin America. These disparities highlight the urgent need for regional harmonization of diagnostic criteria, treatment protocols, and survivorship care to improve outcomes and quality of life for affected patients. *Both autors contributed equally to the study
Santos et al. (Tue,) studied this question.
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