Long-Term Effects of Childhood CNS Germ Cell Tumors
A significant proportion of children with central nervous system (CNS) germ cell tumors (GCTs) present with endocrinopathies, including diabetes insipidus and panhypopituitarism. In most cases, these endocrinopathies are permanent despite tumor control and will need continuous hormone replacement therapy.[1-3]
Although significant improvements in the overall survival of patients with CNS GCTs have occurred, patients face significant late effects based on the location of the primary tumor and its treatment. Treatment-related late effects include the following:
- Each chemotherapeutic agent has its own characteristic long-term side effects.
- Radiation therapy to the areas commonly affected by GCTs is known to cause a decline in patient performance status, visual-field impairments, extraocular movement disturbances, endocrine disorders, and learning disabilities.[4-6]
- Second tumors have been identified in this population, some of which are thought to be related to previous irradiation.
Current clinical trials and therapeutic approaches are directed at minimizing the long-term sequelae of the treatment of CNS GCTs.
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- Jabbour SK, Zhang Z, Arnold D, et al.: Risk of second tumor in intracranial germinoma patients treated with radiation therapy: the Johns Hopkins experience. J Neurooncol 91 (2): 227-32, 2009. [PUBMED Abstract]