782 Multi-agent Neoadjuvant Chemotherapy and Reduced Dose Radiotherapy for Germinoma: Results for 22 Children

INTRODUCTION: Germinomas are highly curable tumors with radiotherapy (50 Gy); however, children are at progressive cognitive and endocrine dysfunction after this traditional craniospinal radiotherapy (RT) treatment course. The use of preradiotherapy neoadjuvant chemotherapy may permit a dose and volume reduction of radiation (30 Gy). Prior clinical trials have produced a 70% complete response rate with single agents. We analyzed our results with multiagent chemotherapy and reduced radiation therapy in children treated from 1998 to 2000. METHODS: We have enrolled 23 children (mean age, 12.5 yr) with histologically confirmed germinoma and negative markers. There were 18 males and 5 females, with 12 tumors located in the suprasellar region, 7 in pineal and 4 in a disseminated region. All the patients were treated with two cycles of carboplatin and etoposide. The radiation dose was based on disease stage and response to chemotherapy. Children with localized disease received involved field RT and those...