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Childhood Central Nervous System Germ Cell Tumors Treatment (PDQ®)

Health Professional Version
Last Modified: 08/14/2014

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 continued replacement therapy.[1-3]

Although significant improvements in the overall survival of CNS GCTs have occurred, patients still face significant late effects secondary to the location of their primary tumor and its treatment. Each chemotherapeutic agent has its own characteristic long-term side effects. Radiation therapy to the areas commonly affected by GCTs is known to cause visual field impairments, extraocular movement disturbances, endocrine disorders, decline in patients' performance status, and learning disabilities.[4-6] Second tumors have been identified in this population, some of which are thought to be related to prior irradiation.[7] Current clinical trials and therapeutic approaches are directed at minimizing the long-term sequelae of the treatment of CNS GCTs.

References
  1. Rosenblum MK, Matsutani M, Van Meir EG: CNS germ cell tumours. In: Kleihues P, Cavenee WK, eds.: Pathology and Genetics of Tumours of the Nervous System. Lyon, France: International Agency for Research on Cancer, 2000, pp 208-14. 

  2. Hoffman HJ, Otsubo H, Hendrick EB, et al.: Intracranial germ-cell tumors in children. J Neurosurg 74 (4): 545-51, 1991.  [PUBMED Abstract]

  3. Jennings MT, Gelman R, Hochberg F: Intracranial germ-cell tumors: natural history and pathogenesis. J Neurosurg 63 (2): 155-67, 1985.  [PUBMED Abstract]

  4. Osuka S, Tsuboi K, Takano S, et al.: Long-term outcome of patients with intracranial germinoma. J Neurooncol 83 (1): 71-9, 2007.  [PUBMED Abstract]

  5. Balmaceda C, Finlay J: Current advances in the diagnosis and management of intracranial germ cell tumors. Curr Neurol Neurosci Rep 4 (3): 253-62, 2004.  [PUBMED Abstract]

  6. Odagiri K, Omura M, Hata M, et al.: Treatment outcomes, growth height, and neuroendocrine functions in patients with intracranial germ cell tumors treated with chemoradiation therapy. Int J Radiat Oncol Biol Phys 84 (3): 632-8, 2012.  [PUBMED Abstract]

  7. 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]