ESTRO meets Asia 2024 - Abstract Book

S111

Interdisciplinary – CNS

ESTRO meets Asia 2024

278

Digital Poster

Radiotherapy Strategies for Germinoma: Comparing Regional to Local Rt vs. Vice Versa- Our Experience

Felix Wijovi 1,2 , Denny Handoyo Kirana 2 , Maria Claudia 1 , Patricia Angel 1

1 Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. 2 Department of Radiation Oncology, Mochtar Riady Comprehensive Cancer Centre, South Jakarta, Indonesia

Purpose/Objective:

Germinoma, a rare type of radio-sensitive tumour affecting the central nervous system, presents challenging treatment considerations. Standard protocols suggest sequential regional followed by local radiotherapy regimen. However, the variability in tumour response to initial regional irradiation complicates the precise localization of the target. In light of these challenges, our review aims to evaluate the efficacy & outcomes of the established regional followed by local radiotherapy strategy for germinoma, comparing it with the approach of local targeting before regional irradiation.

Material/Methods:

We conducted a search across PubMed, Embase & Cochrane Library on studies regarding germinoma radiotherapy. Our focus is on comparing the efficacy of regional followed by local radiotherapy versus regional followed by local radiotherapy. We analysed regional recurrence rates & overall survival outcomes. We'll also incorporate insights from our centre’s experience, detailing the treatment outcomes & toxicities.

Results:

Our systematic search included 189 germinoma patients undergoing postoperative radiotherapy. Those receiving regional followed by local radiotherapy showed significantly higher rates of regional recurrence compared to local followed by regional radiotherapy (15 versus 4 regional recurrences, respectively). This may be due to inaccurate local target after regional radiotherapy. We included 18 patients from our centre, with median age of 16 years old (9-25 years old), all males. 10 received local followed by regional radiotherapy, 8 of them vice versa. Nearly all showed complete response, while 2 showed partial response, one from each treatment group. In terms of toxicities, both treatment group reported similar toxicities, including headache & nausea. After 2 year follow-up, both treatment group had 100% survival rate. However, one patient in our centre from the regional followed by local radiotherapy group showed regional recurrence.

Conclusion:

In conclusion, our analysis suggests that optimizing radiotherapy strategies for germinoma is necessary. The current guideline of regional followed by local radiotherapy may not be the most effective approach, as it can lead to an ambiguous target for the regional followed by local radiotherapy. Instead, considering a local followed by regional radiotherapy may be a more suitable option. Further data is required to confirm this findings.

Keywords: Germinoma, Treatment, Radiotherapy