Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience
BackgroundGerm cell tumors (GCT) account for a minority of central nervous system (CNS) malignancies, highly prevalent in adolescents and young adults. Despite their aggressive biological behavior, prognosis is excellent in most cases with risk stratified treatment, consisting in a combination of ch...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1259403/full |
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| author | Giada Del Baldo Giada Del Baldo Sabina Vennarini Maristella Toniutti Rachid Abbas Stefano Lorentini Eleonora Piccirilli Eleonora Piccirilli Antonella Cacchione Giacomina Megaro Valentina Di Ruscio Maria Antonietta De Ioris Andrea De Salvo Giulia Albino Sabrina Rossi Giovanna Stefania Colafati Giovanna Stefania Colafati Andrea Carai Angela Mastronuzzi |
| author_facet | Giada Del Baldo Giada Del Baldo Sabina Vennarini Maristella Toniutti Rachid Abbas Stefano Lorentini Eleonora Piccirilli Eleonora Piccirilli Antonella Cacchione Giacomina Megaro Valentina Di Ruscio Maria Antonietta De Ioris Andrea De Salvo Giulia Albino Sabrina Rossi Giovanna Stefania Colafati Giovanna Stefania Colafati Andrea Carai Angela Mastronuzzi |
| author_sort | Giada Del Baldo |
| collection | DOAJ |
| description | BackgroundGerm cell tumors (GCT) account for a minority of central nervous system (CNS) malignancies, highly prevalent in adolescents and young adults. Despite their aggressive biological behavior, prognosis is excellent in most cases with risk stratified treatment, consisting in a combination of chemotherapy and radiotherapy. Whole ventricular irradiation (WVI) and craniospinal irradiation, the treatment of choice for localized and metastatic disease, pose significant risk of collateral effects, therefore proton beam radiation (PBT) has been recently proposed for its steep dose fallout.Materials and methodsWe report our experience in a consecutive series of 17 patients treated for CNS GCT at our Institution from 2015 to 2021.ResultsMost frequent lesion location were sellar/suprasellar (35%) and bifocal germinoma (35%), followed by pineal (18%) and thalamic (12%). Two patients (12%), had evidence of disseminated disease at the time of diagnosis. At the latest follow-up all but one patient showed complete response to treatment. The only relapse was successfully rescued by additional chemotherapy and PBT. PBT was well tolerated in all cases. No visual, neurological or endocrinological worsening was documented during and after treatment. Neuropsychological evaluation demonstrated preservation of cognitive performance after PBT treatment.ConclusionsOur data, albeit preliminary, strongly support the favourable therapeutic profile of PBT for the treatment of CNS germ cell tumors. |
| first_indexed | 2024-03-11T19:58:28Z |
| format | Article |
| id | doaj.art-5931247dd8ba44e0a7f045301eb3538d |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-03-11T19:58:28Z |
| publishDate | 2023-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-5931247dd8ba44e0a7f045301eb3538d2023-10-04T14:02:14ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-10-011310.3389/fonc.2023.12594031259403Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experienceGiada Del Baldo0Giada Del Baldo1Sabina Vennarini2Maristella Toniutti3Rachid Abbas4Stefano Lorentini5Eleonora Piccirilli6Eleonora Piccirilli7Antonella Cacchione8Giacomina Megaro9Valentina Di Ruscio10Maria Antonietta De Ioris11Andrea De Salvo12Giulia Albino13Sabrina Rossi14Giovanna Stefania Colafati15Giovanna Stefania Colafati16Andrea Carai17Angela Mastronuzzi18Department of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Experimental Medicine, Sapienza University of Rome, Rome, ItalyPediatric Radiotherapy Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, ItalyDepartment of Medicine DAME-Division of Pediatrics, University of Udine, Udine, ItalyCESP, INSERM, Université Paris Sud, Villejuif, FranceMedical Physics Department, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, ItalyDepartment of Diagnostic Imaging Oncological Neuroradiology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, University of Chieti, Chieti, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyPathology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Diagnostic Imaging Oncological Neuroradiology Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Neuroscience, Imaging and Clinical Sciences, University of Chieti, Chieti, Italy0Neurosurgery Unit, Department of Neurosciences, Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyDepartment of Pediatric Haematology and Oncology, and Cell and Gene Therapy Bambino Gesù Children’s Hospital, IRCCS, Rome, ItalyBackgroundGerm cell tumors (GCT) account for a minority of central nervous system (CNS) malignancies, highly prevalent in adolescents and young adults. Despite their aggressive biological behavior, prognosis is excellent in most cases with risk stratified treatment, consisting in a combination of chemotherapy and radiotherapy. Whole ventricular irradiation (WVI) and craniospinal irradiation, the treatment of choice for localized and metastatic disease, pose significant risk of collateral effects, therefore proton beam radiation (PBT) has been recently proposed for its steep dose fallout.Materials and methodsWe report our experience in a consecutive series of 17 patients treated for CNS GCT at our Institution from 2015 to 2021.ResultsMost frequent lesion location were sellar/suprasellar (35%) and bifocal germinoma (35%), followed by pineal (18%) and thalamic (12%). Two patients (12%), had evidence of disseminated disease at the time of diagnosis. At the latest follow-up all but one patient showed complete response to treatment. The only relapse was successfully rescued by additional chemotherapy and PBT. PBT was well tolerated in all cases. No visual, neurological or endocrinological worsening was documented during and after treatment. Neuropsychological evaluation demonstrated preservation of cognitive performance after PBT treatment.ConclusionsOur data, albeit preliminary, strongly support the favourable therapeutic profile of PBT for the treatment of CNS germ cell tumors.https://www.frontiersin.org/articles/10.3389/fonc.2023.1259403/fullCNS germ cell tumorschemotherapyprotontherapyoutcomeside effectspediatric brain tumors |
| spellingShingle | Giada Del Baldo Giada Del Baldo Sabina Vennarini Maristella Toniutti Rachid Abbas Stefano Lorentini Eleonora Piccirilli Eleonora Piccirilli Antonella Cacchione Giacomina Megaro Valentina Di Ruscio Maria Antonietta De Ioris Andrea De Salvo Giulia Albino Sabrina Rossi Giovanna Stefania Colafati Giovanna Stefania Colafati Andrea Carai Angela Mastronuzzi Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience Frontiers in Oncology CNS germ cell tumors chemotherapy protontherapy outcome side effects pediatric brain tumors |
| title | Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience |
| title_full | Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience |
| title_fullStr | Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience |
| title_full_unstemmed | Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience |
| title_short | Unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow-up in central nervous system germ cell tumors: a single center experience |
| title_sort | unraveling the impact of upfront chemotherapy and proton beam therapy on treatment outcome and follow up in central nervous system germ cell tumors a single center experience |
| topic | CNS germ cell tumors chemotherapy protontherapy outcome side effects pediatric brain tumors |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1259403/full |
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