Ana Carolina Rezende, Presenter: Nothing to Disclose

Eduardo Weltman, Abstract Co-Author: Nothing to Disclose

Juliana Karassawa Helito, Abstract Co-Author: Nothing to Disclose

Michael Chen, Abstract Co-Author: Nothing to Disclose

Nasjla Saba, Abstract Co-Author: Nothing to Disclose

Andrea Cappellano, Abstract Co-Author: Nothing to Disclose

Jose Carlos Cruz, Abstract Co-Author: Nothing to Disclose

Roberto Sakuraba, Abstract Co-Author: Nothing to Disclose

Purpose / Objectives: Intracranial germ cell tumors are a heterogeneous group of neoplasms with high cure rates due to its sensitivity to radiation and chemotherapy (CT). However, recurrences are not uncommon after focal-field radiotherapy (RT) and the whole ventricle irradiation appears to be a more attractive approach in this scenario. The aim of this retrospective study is to report our experience in treating these tumors with CT followed by Intensity Modulated Radiation Therapy (IMRT) to whole ventricles and a tumor bed boost.Methods and Materials: Between January 2006 and January 2014, 24 patients with pathologically or clinically diagnosed CNS Germ cell tumors were reviewed at our institution. The first treatment approach was based on CT combined to RT, and 7 patients underwent tumor resection as well. All of them had whole ventricle irradiation with doses ranging from 18 Gy to 36 Gy , and 22 patients received an additional tumor bed boost ranging from 30.6 Gy to 54 Gy. IMRT was the technique of choice in all these cases and Volumetric Modulated Arc Therapy was used to treat 66% of them. The outcomes were recorded.Results: The 24 patients are alive, although three recurred with time to relapse ranging from 4 to 26 months. All of them had cranial spinal fluid (CSF) recurrence and two presented with spinal nodules. They were all treated with CT followed by a second course of radiation, consisting on craniospinal radiotherapy with an additional dose to spine residual masses. The 3 patients are alive, and only one of them has persistent disease.Conclusions: Whole ventricle irradiation following CT seems to be an effective approach for intracranial germ cell tumors. Efforts should be made to better identify the risk factors for spinal spread and provide an adequate selection of the best candidates for whole ventricle irradiation.

Rezende, A, Weltman, E, Helito, J, Chen, M, Saba, N, Cappellano, A, Cruz, J, Sakuraba, R, Outcomes of CNS Germ Cell Tumor Patients Treated with Intensity Modulated Radiation Therapy and Volumetric Modulated Arc Therapy to Whole Ventricle.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14044011.html