PURPOSE: Intracranial germ cell @entity5 are rare, radiosensitive @entity5 seen most commonly in the second and third decades of life. Radiotherapy alone has been the primary treatment modality for @entity3438 , and is used with chemotherapy for @entity5 . Stereotactic radiotherapy techniques minimize the volume of surrounding normal tissue irradiated and, hence, the late radiation morbidity. This study reports our experience with stereotactic radiotherapy in this group of @entity5 . METHODS AND MATERIALS: Between December 1992 and December 1998, 18 @entity1 with @entity2971 were treated with stereotactic radiotherapy. A total of 23 histologically proven @entity5 were treated. Thirteen @entity1 had a histologic diagnosis of @entity3438 , and 5 @entity1 had @entity3438 with nongerminomatous elements. Of those @entity1 with a histologic diagnosis of @entity3438 , 5 had multiple midline @entity5 . The median age of the @entity1 was 12.9 years (range, 5.6-17.5 years). RESULTS: A boost using stereotactic radiotherapy was delivered to 19 @entity5 following whole-brain radiation in 8 cases and craniospinal radiation in 11 cases. Three @entity5 were treated with stereotactic radiotherapy to the @entity5 volume alone following chemotherapy, and 1 @entity5 received a boost using stereotactic radiosurgery following craniospinal radiation. A median dose of 2520 cGy (range, 1500-3600) cGy was given to the whole brain, and a median dose of 2160 (range, 2100-2600) cGy was given to the spinal field. The median boost dose to the @entity5 was 2600 (range, 2160-3600) cGy, given by stereotactic radiotherapy delivered to the 95% isodose line. At a median follow-up time of 40 (range, 12-73) months, no local or marginal recurrences were reported in @entity1 with @entity3438 . Two @entity1 with @entity5 have relapsed. One had elevation of @entity5 markers only at 37 months following treatment, and the other had persistent disease following chemotherapy and radiation therapy. Eight @entity1 documented @entity1640 ; in 7 (87.5%) of these @entity1 , the dysfunction was present before commencing radiotherapy. Four @entity1 (22%) developed newly diagnosed @entity2010 following surgery. Three @entity1 (17%) received antidepressant medication at follow-up. CONCLUSION: Our series shows that stereotactic radiotherapy is achievable and well tolerated in this group of @entity1 . Longer follow-up is required to fully assess the impact on long-term @entity137 . Psychologic assessment of mood and affect should be performed as part of routine follow-up in this group of adolescent @entity1 .

Stereotactic radiotherapy for pediatric XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity'] @entity1640 :: ('MESH:D007027', 'Disease') :: ['pituitary-hypothalamic dysfunction'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'nongerminomatous tumors', 'tumors'] @entity2971 :: ('MESH:D009373', 'Disease') :: ['intracranial germ cell tumors'] @entity3438 :: ('MESH:D018237', 'Disease') :: ['germinoma', 'germinomas'] @entity2010 :: ('MESH:D003919', 'Disease') :: ['diabetes insipidus']
@entity2971 :: (MESH:D009373,Disease) :: ['intracranial germ cell tumors']
