OBJECTIVE: To evaluate the role of neoadjuvant chemotherapy and radiotherapy in the @entity149 in 38 @entity1 who received definitive treatment and were followed-up >5 years between 1980-2009. METHODS: The median age at diagnosis and follow-up period were 16.5 years and 128.3 months, respectively. Treatment was irradiation alone or adjuvant @entity902 -based chemotherapy followed by reduced-dose local irradiation. Seven @entity1 progressed at 12.9-133.9 months and 1 died of disease 89.3 months after therapy initiation. RESULTS: The treatment strategies were divided into three groups: Group A (1980-1988, n=5): whole brain with local irradiation; Group B (1989-2002, n=16): chemotherapy with or without reduced irradiation dose; and Group C (2003-2009, n=17): neoadjuvant chemotherapy (3 courses) followed by 30.6-Gy whole ventricle irradiation for @entity1 with localized complete response, and additional local boost of 19.8-Gy for others. There were 7 recurrent cases, all in Group B. The progression-free survival was significantly longer in Groups A and C vs. Group B (p<0.001). Decreased Karnofsky performance status was observed in 2 (40%), 6 (37.5%), and 0 cases in Groups A-C, respectively. The main reasons for the good results in Group C might be the neoadjuvant chemotherapy with whole ventricle radiotherapy and introduction of neuroendoscopy, especially for @entity979 , resulting in a substantial reduction of time from the diagnosis to 1(st) treatment. CONCLUSIONS: Chemotherapy followed by whole ventricle radiotherapy, with or without local boost, and with use of neuroendoscopy results in good disease-control without late complications in @entity3438 @entity1 .

Improvement of Long-term Results with Neoadjuvant Chemotherapy and Radiotherapy for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity979 :: ('MESH:D010871', 'Disease') :: ['pineal lesions'] @entity149 :: ('MESH:D002493', 'Disease') :: ['treatment of central nervous system germinomas'] @entity902 :: ('MESH:D010984', 'Chemical') :: ['platinum'] @entity3438 :: ('MESH:D018237', 'Disease') :: ['germinoma']
@entity149 :: (MESH:D002493,Disease) :: ['Central Nervous System Germinoma']
