立体定向放射外科针对颅内非生殖性生殖细胞瘤常规放疗后残留病灶的疗效分析.

Objective To evaluate the safety and efficacy of stereotatic radiosurgery（SRS） in treating residual lesions of pineal non-germinomatous germ cell tumors（NGGCTs） after conventional radiotherapy. Methods The clinical data of patients with intracranial germ cell tumors admitted to Guangdong Sanjiu Brain Hospital from January 2008 to December 2018 who diagnosed with pineal NGGCTs pathologically or clinically were analyzed retrospectively. Among those, the patients received conventional radiotherapy with SRS were included. The residual lesions after radiotherapy were defined with a maximum diameter ＞10 mm. Prognosis related parameters such as local control rate, progress-free survival, overall survival and treatment-related toxicity were determined. Results Total of 27 patients were included in this study. Both of them were males with the median age of 16 years old. The median follow-up time was 34 months（range 8-142 months）. The objective response rate and disease control rate were 71.4% and 95.2%, respectively. Three-year progression-free survival rate was 85.2% and 3-year total survival rate was 88.0%. The univariate analysis revealed that both age and concurrent chemotherapy were not correlated with the prognosis（P=0.286,0.824）. Partial tumor resection before radiotherapy and chemotherapy, AFP＞500 ng/mL, and less than 4 cycles of adjuvant chemotherapy were poor prognostic factors（P=0.037,0.010,0.006）. Moreover, no acute radiation injury was observed after SRS. Only 1 out of 27 patients（ 3. 7%） had brain neurotoxicity related to a prolonged course of radiochemotherapy.Conclusions SRS for residual lesions of NGGCTs following conventional radiotherapy appears to be well tolerant and improved local control. However, the therapeutic efficacy of conventional radiotherapy combined with SRS warrants further investigations in a large-scale randomized controlled clinical trials. [ABSTRACT FROM AUTHOR]