A Retrospective Study Of Suprasellar Tumor-like Lesions And Intracranial Germinomas

Purpose:To analyze the outcomes of radiotherapy for suprasellar tumor-like lesions and intracranial germinomas.Methods:The study group consisted133patients with intracranial germinoma (24patients with pathologically verified germinoma and109clinically diagnosed with germinoma by clinical and neuroradiologic signs) and9NGGCT-mixed tumor. The remain26patients were no remission for diagnostic radiotherapy. All patients were treated by radiotherapy between Jan.1996and Aug.2013. The median age at diagnosis was15years (range,4-51), and various radiation doses and treatment fields were used. Serum and/or CSF beta-human chorionic gonadotropin (p-HCG) levels were elevated in104patients. The median follow-up was60months (range,4-216).Results:The5-years overall survival and relapse-free survival for133patients with intracranial germinoma was92.9%±2.5%and88.9%±3.1%. The10-years overall survival and relapse-free survival was89.8%Q3.9%å'Œ68.7%±8.2%. Relapses were noted in18patients,7of whom relapsed in-field and11of whom relapsed out of field.1of9patients with NGGCT-mixed tumor relapsed and died of the disease.3of26no remission for diagnostic radiotherapy patients had been diagnosed as Langerhan’s cell histiocytosis by surgical biopsy, the other one patient diagnosed as inflammation and Rathke cyst by surgical resection. Serum and CSF β-HCG levels were no significant with treatment outcome.22patients with neurocognitive decline appeared after radiotherapy. There were31patients needing new Endocrine hormone replacement compared with pre-radiotherapy and26patients no more needing hormone replacement after radiotherapy.Conclusion:Suprasellar tumor-like lesions contain a variety disease. Diagnosis and differential diagnosis are very important for treatment. The WVI+PB is sufficient for germinoma with local disease. There is no evidence that serum and/or CSF β-HCG levels increase need Cranial spinal irradiation.