Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis
Abstract Background To determine the optimal treatment modality for intracranial germinoma (IG). Materials and methods A search of Medline, Embase, Web of Science and Cochrane Library was conducted up to April, 2024. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup a...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12885-024-13323-1 |
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| author | Zhirui Zhou Jiabing Liu Qi Yue Lingxiao Chen Xiwei Zhang Xin Lin Lin Zheng Enmin Wang Yang Wang Ying Mao |
| author_facet | Zhirui Zhou Jiabing Liu Qi Yue Lingxiao Chen Xiwei Zhang Xin Lin Lin Zheng Enmin Wang Yang Wang Ying Mao |
| author_sort | Zhirui Zhou |
| collection | DOAJ |
| description | Abstract Background To determine the optimal treatment modality for intracranial germinoma (IG). Materials and methods A search of Medline, Embase, Web of Science and Cochrane Library was conducted up to April, 2024. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup analysis was applied according to radiotherapy (RT) alone or with chemotherapy (CTx). Results Total 37 studies were included in systematic review. Most IG patients were treated with biopsy or resection followed by RT with or without CTx. Prognosis of IG patients with different surgical resection is similar. Meta-analyses demonstrated focal field RT were with higher recurrence rate compared with craniospinal irradiation (CSI) [RR = 7.128, 95% CI (5.083, 9.995)], whole-brain RT (WBRT) [RR = 4.094, 95% CI (2.923, 5.735)] or whole-ventricle RT (WVRT) [RR = 3.361, 95% CI (2.126, 5.312)]; both WBRT and WVRT were also with higher recurrence compared with CSI; but no significant difference in recurrence and mortality between WVRT and WBRT. Total 24 studies reported treatment-related acute and/or late toxicity, combination CTx increased acute toxic, and expanded RT field and/or dose increased late toxicity. Conclusion Based on our findings, focal field RT is not recommended regardless of whether combined with CTx for intracranial pure germinoma. Although CSI is associated with better local control than other reduced-field RT, considering the potential toxicity and pattern of relapse, whole ventricles irradiation is more reasonable for localized or nonmetastatic germinoma. Reduced-dose CSI with or without chemotherapy is effective in metastatic or disseminated IG. |
| format | Article |
| id | doaj-art-34d94d8d25b14de3ade76ecf5e0a2b72 |
| institution | Kabale University |
| issn | 1471-2407 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj-art-34d94d8d25b14de3ade76ecf5e0a2b722025-01-12T12:27:43ZengBMCBMC Cancer1471-24072025-01-0125112310.1186/s12885-024-13323-1Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysisZhirui Zhou0Jiabing Liu1Qi Yue2Lingxiao Chen3Xiwei Zhang4Xin Lin5Lin Zheng6Enmin Wang7Yang Wang8Ying Mao9Radiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan UniversityRadiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan UniversityNational Center for Neurological DisordersDepartment of Orthopedics, Advanced Medical Research Institute, Cheeloo College of Medicine, Qilu Hospital of Shandong University, Shandong University Centre for Orthopedics, Shandong UniversityDepartment of Oncology, Jing’an District Central Hospital, Fudan UniversityNursing Department, Huashan Hospital, Shanghai Medical College, Fudan UniversityDepartment of Radiation Oncology, Taizhou Cancer HospitalNational Center for Neurological DisordersRadiation Oncology Center, Huashan Hospital, Shanghai Medical College, Fudan UniversityNational Center for Neurological DisordersAbstract Background To determine the optimal treatment modality for intracranial germinoma (IG). Materials and methods A search of Medline, Embase, Web of Science and Cochrane Library was conducted up to April, 2024. Pooled risk ratio (RR) and 95% confidence interval (CI) were calculated. Subgroup analysis was applied according to radiotherapy (RT) alone or with chemotherapy (CTx). Results Total 37 studies were included in systematic review. Most IG patients were treated with biopsy or resection followed by RT with or without CTx. Prognosis of IG patients with different surgical resection is similar. Meta-analyses demonstrated focal field RT were with higher recurrence rate compared with craniospinal irradiation (CSI) [RR = 7.128, 95% CI (5.083, 9.995)], whole-brain RT (WBRT) [RR = 4.094, 95% CI (2.923, 5.735)] or whole-ventricle RT (WVRT) [RR = 3.361, 95% CI (2.126, 5.312)]; both WBRT and WVRT were also with higher recurrence compared with CSI; but no significant difference in recurrence and mortality between WVRT and WBRT. Total 24 studies reported treatment-related acute and/or late toxicity, combination CTx increased acute toxic, and expanded RT field and/or dose increased late toxicity. Conclusion Based on our findings, focal field RT is not recommended regardless of whether combined with CTx for intracranial pure germinoma. Although CSI is associated with better local control than other reduced-field RT, considering the potential toxicity and pattern of relapse, whole ventricles irradiation is more reasonable for localized or nonmetastatic germinoma. Reduced-dose CSI with or without chemotherapy is effective in metastatic or disseminated IG.https://doi.org/10.1186/s12885-024-13323-1Intracranial germinomaSurgical resectionRadiotherapyChemotherapyMeta-analysis |
| spellingShingle | Zhirui Zhou Jiabing Liu Qi Yue Lingxiao Chen Xiwei Zhang Xin Lin Lin Zheng Enmin Wang Yang Wang Ying Mao Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis BMC Cancer Intracranial germinoma Surgical resection Radiotherapy Chemotherapy Meta-analysis |
| title | Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis |
| title_full | Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis |
| title_fullStr | Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis |
| title_full_unstemmed | Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis |
| title_short | Optimal treatment approach for intracranial germinoma: a systematic review and meta-analysis |
| title_sort | optimal treatment approach for intracranial germinoma a systematic review and meta analysis |
| topic | Intracranial germinoma Surgical resection Radiotherapy Chemotherapy Meta-analysis |
| url | https://doi.org/10.1186/s12885-024-13323-1 |
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