{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T03:39:29Z","timestamp":1794109169844,"version":"4.8.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"the Asian CNS Germ Cell Tumor Consortium"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term efficacy data supporting the use of reduced-dose radiotherapy (rdRT) alone for intracranial pure germinoma remain limited. In this study, we evaluated the long-term efficacy and safety of rdRT alone in patients with this condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed the data of 139 patients with intracranial pure germinoma treated with radiotherapy (RT) alone, using whole-ventricle irradiation (73.6%), whole-brain irradiation (9.3%), or craniospinal irradiation (CSI, 17.1%). Patients who had M\u2009+\u2009disease were included, whereas those treated with local RT alone were excluded. The most commonly prescribed dose to gross tumors was 30.0-30.6 Gy delivered in 15-17 fractions (median total dose, 35.5 Gy). The median extended-field (whole-ventricle, whole-brain, or craniospinal) dose was 23.4 Gy. Survival outcomes were analyzed according to total RT dose, whole-ventricle dose, RT field, and disease distribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At a median follow-up of 102 months, the 5- and 10-year event-free survival (EFS) rates were 90.0% and 88.4%, respectively, and the corresponding overall survival rates were 100.0% and 98.4%. Dose escalation beyond 30.6 Gy did not improve EFS (P\u2009=\u20091.000). A whole-ventricle dose of 18 Gy was not associated with inferior EFS compared with &amp;gt;18 Gy (P\u2009=\u2009.155). In patients with bifocal disease (suprasellar and pineal, n\u2009=\u200924), CSI significantly improved 5-year EFS (100.0% vs 63.3%, P\u2009=\u2009.040). In the study-defined optimal RT group (total dose \u226530 Gy, excluding bifocal disease without CSI; n\u2009=\u2009125), the 3- and 5-year EFS rates were 94.2% and 92.4%, respectively. No grade \u22653 acute or late RT-related toxicities or secondary malignancies were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RdRT alone, administered with an appropriate dose and RT field according to disease status, provided excellent long-term tumor control with minimal toxicity. Tumor and extended-field doses of 30.6 Gy and 18 Gy, respectively, appeared adequate. A prospective phase 2 trial is planned to further validate this treatment strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noag219","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:25:47Z","timestamp":1788521147000},"source":"Crossref","is-referenced-by-count":3,"title":["Reduced-dose radiotherapy without chemotherapy for intracranial germinomas: Results from an Asian multicenter study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0631-7549","authenticated-orcid":false,"given":"Chan Woo","family":"Wee","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]},{"name":"Brain Research Institute, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8964-6275","authenticated-orcid":false,"given":"Hwa Kyung","family":"Byun","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yongin Severance Hospital, Yonsei University College of Medicine , Yongin,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Wei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Heavy Particles and Radiation Oncology, Taipei Veterans General Hospital , Taipei,","place":["Taiwan"]},{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University , Taipei,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9966-5157","authenticated-orcid":false,"given":"Jaeho","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8833-7457","authenticated-orcid":false,"given":"Yu-Mei","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Heavy Particles and Radiation Oncology, Taipei Veterans General Hospital , Taipei,","place":["Taiwan"]},{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University , Taipei,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7571-3123","authenticated-orcid":false,"given":"Yen-Lin","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Pediatric Oncology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University , Taipei,","place":["Taiwan"]},{"name":"Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University , Taipei,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8210-170X","authenticated-orcid":false,"given":"Dong-Seok","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9441-7354","authenticated-orcid":false,"given":"Kyu-Won","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8936-1205","authenticated-orcid":false,"given":"Jung Woo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7124-7818","authenticated-orcid":false,"given":"Chuhl Joo","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine , Seoul,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I-Chun","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Heavy Particles and Radiation Oncology, Taipei Veterans General Hospital , Taipei,","place":["Taiwan"]},{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University , Taipei,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9084-855X","authenticated-orcid":false,"given":"Cheng-Shien","family":"Shieh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Taipei Medical University Hospital, Taipei Medical University , Taipei,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3375-7072","authenticated-orcid":false,"given":"Chang-Ok","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, CHA Bundang Medical Center, CHA University , Seongnam,","place":["Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4075-6227","authenticated-orcid":false,"given":"Tai-Tong","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Pediatric Neurosurgery, Department of Neurosurgery, Taipei 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