Treatment of Newly Diagnosed Childhood Teratomas
Treatment Options for Newly Diagnosed Childhood Teratomas
Teratomas are designated as mature or immature based on the absence or presence of differentiated tissues. The Japanese Pediatric Brain Tumor Study Group stratifies teratomas for classification and intensity of treatment (chemotherapy and radiation) into the good-risk (mature teratomas) and intermediate-risk (immature teratomas) groups (refer to Table 3), while the Children’s Oncology Group includes immature teratomas with other nongerminomatous germ cell tumors.
Treatment options for newly diagnosed childhood teratomas include the following:
- Adjuvant therapy, for patients who had a subtotal resection (controversial).
- Focal radiation therapy.
- Stereotactic radiosurgery.
The primary treatment for teratomas is maximal surgical resection. Adjuvant treatment in the form of focal radiation therapy and/or adjuvant chemotherapy for subtotally resected tumors is controversial, with small institutional series suggesting potential utility for the use of stereotactic radiosurgery.[1,2][Level of evidence: 3iA]