Treatment
Biopsy was performed in 46 patients and gross tumour resection in 8. Forty-two children received chemotherapy, which differed across time and centres, according to the International CNS Germ Cell Tumour Study Group and the Children’s Oncology Group guidelines 8,24,25. For 7 relapsed GCTs rescue treatment consisted in an aggressive approach of myeloablative high-dose chemotherapy (Etoposide/Thiotepa) followed by autologous stem cell transplant.
Radiation therapy was delivered to 50/55 patients (90%), with a median age of 11.6 years (range 5.4-18.3) at first radiation treatment. Among them, 13/50 patients (26%) received craniospinal irradiation (CSI) of 24-30.6 Gy (with boosted metastasis irradiation of 16 Gy in 8 cases), 9/50 patients (18%) whole brain irradiation of 54 Gy, 2/50 patients (4%) whole ventricular field irradiation (WVI) of 24 Gy without primary site simultaneous integrated boost, 21/50 patients (42%) WVI of 24 Gy with boost (16 Gy) and 5/50 patients (10%) received focal irradiation only (40-54 Gy).