Current Standard of Care: CNS Germinoma

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Maforce

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For pure CNS germinoma, what do you do at your institution?

1) Carbo/Etop x4c --> WVI 24Gy --> boost to 30-36 Gy

vs

2) WVI 24 Gy --> boost to 45 Gy

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What stage are you talking about?
Unifocal disease or involvement of more than 1 ventricle?
 
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I'd do whole ventricular RT with 24 Gy and boost primary site to 36 Gy.
Risk of dessimination is minimal.

(I firmly believe that 36 Gy are sufficient in germinoma. It's seminoma!)
 
I'd do whole ventricular RT with 24 Gy and boost primary site to 36 Gy.
Risk of dessimination is minimal.

(I firmly believe that 36 Gy are sufficient in germinoma. It's seminoma!)
chemo or no chemo?
 
Current COG protocol (ACNS 1123) includes chemo for all patients and response-based RT dosing (see below). This is what we use for all our CNS germinomas (adult or child).



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