{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T22:55:58Z","timestamp":1792364158662,"version":"4.4.0"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The authors analyzed the efficacy of intensive chemotherapy followed by reduced-dose and reduced-field irradiation for intracranial germ cell tumors (GCTs) and evaluated the long-term late effects caused by chemoradiotherapy (CRT).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors performed a retrospective study. The subjects were 24 patients who received CRT between April 1994 and April 2015. After surgery, intensive chemotherapy followed by reduced-dose and reduced-field irradiation was administered. For those with pure germinoma, who comprised the \u201cgood prognosis\u201d group, five courses of conventional-dose chemotherapy (CDC) were administered, and radiotherapy (24 Gy) was applied to the whole ventricle. For all others, defined as the \u201cintermediate and poor prognosis\u201d group, two or three courses of CDC and high-dose chemotherapy were administered with peripheral blood stem cell transplantation and radiotherapy (24\u201330 Gy) applied to the whole ventricle or a larger field with or without local boost irradiation (20 Gy), which was applied as needed.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The median period of follow-up was 112.5 months (range 28\u2013261 months), and the 5-\/10-year overall and progression-free survival rates were 100%\/83.5% and 91.3%\/86.5%, respectively. The 5-\/10-year overall survival rates determined based on the histological subtypes were 100%\/100% for pure germinoma and 93.8%\/78.7% for others, respectively. The late toxicities were as follows: endocrine disorder (33% in pure germinoma, 56% in others), involuntary movements (17% in pure germinoma, 39% in others), ear and labyrinth disorders (17% in pure germinoma, 33% in others), and psychiatric disorders (0% in pure germinoma, 33% in others). Nineteen of 24 patients underwent MRI (T2*- or susceptibility-weighted imaging) after radiotherapy, and 16 (84%) of those 19 patients had microbleeds detected, while 2 (10.5%) had radiation-induced cavernous vascular malformations detected.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Intensive chemotherapy followed by reduced-dose and reduced-field irradiation for intracranial GCTs had the same outcome as that reported in the literature, but late adverse effects after treatment were observed. Almost all of the complications were relatively mild but had the potential to lead to psychiatric disorders and intracranial hemorrhaging.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2018.9.peds18181","type":"journal-article","created":{"date-parts":[[2019,2,27]],"date-time":"2019-02-27T00:51:48Z","timestamp":1551228708000},"page":"317-324","source":"Crossref","is-referenced-by-count":16,"title":["Long-term follow-up of intensive chemotherapy followed by reduced-dose and reduced-field irradiation for intracranial germ cell tumor"],"prefix":"10.3171","volume":"23","author":[{"given":"Akinori","family":"Takada","sequence":"first","affiliation":[{"name":"Departments of Radiation Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Ii","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Ise Red Cross Hospital, Ise City, Mie;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Hirayama","sequence":"additional","affiliation":[{"name":"Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemi","family":"Toyoda","sequence":"additional","affiliation":[{"name":"Pediatrics, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Matsubara","sequence":"additional","affiliation":[{"name":"Neurosurgery, Mie University Hospital, Tsu City, Mie;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Toyomasu","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Departments of Radiation Oncology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Daimon","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Hyogo College of Medicine, Nishinomiya City, Hyogo; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Sakuma","sequence":"additional","affiliation":[{"name":"Departments of Radiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihito","family":"Nomoto","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mie University Graduate School of Medicine, Tsu City, Mie, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neuro Oncol","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1093\/neuonc\/nou311","article-title":"Long-term outcomes and late effects for childhood and young adulthood intracranial germinomas","volume":"17","author":"Acharya S","year":"2015","unstructured":"Acharya S, DeWees T, Shinohara ET, Perkins SM: Long-term outcomes and late effects for childhood and young adulthood intracranial germinomas. 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