P14.06.A TREATMENT OUTCOME FOR INTRACRANIAL GERM CELL TUMOR (ICGCT): EXPERIENCE FROM A SINGLE TERTIARY CENTRE IN INDIA

Abstract BACKGROUND Intracranial germ cell tumors are fairly rare tumors occurring mostly in children or young adults with a comparatively good prognosis. Historically, ICGCT were treated with cranio-spinal irradiation (CSI); however, the current standard of care for localised ICGCT, in particular germinomas, is more conformal treatment like whole ventricle radiation followed by tumor bed boost (WV+TB), without compromising the results. We report our experience of treatment outcome of patients treated consecutively. MATERIAL AND METHODS We report our experience in a consecutive series of 19 patients treated for ICGCT at our institution from 2001 to 2024. After surgery (biopsy / decompression) and chemotherapy (Cisplatin or Carboplatin + Etoposide +/- Ifosfamide), all patients received radiotherapy with a mean dose of 45Gy. Sixteen (84.2%) patients underwent WV+TB irradiation, while 3 (15.8%) received CSI. RESULTS Median age at diagnosis was 14 years (range: 5-30 years) and 15 (78.9%) patients were male. Median follow-up for the cohort was 97 months (10 months - 244 months). Sixteen patients had germinoma and 3 patients had non-germinomatous germ cell tumors (NGGCT). The primary disease sites were pineal gland (57.8%) and suprasellar region (26.3%). The 5/10-year overall survival (OS) and progression-free survival (PFS) of the entire cohort were 94.4% / 87.2% and 88% / 88%. The 5/10-year OS of pure germinoma was 100% / 91.7%. Two (10.5%) patients progressed and died of their disease. 5 (26.3%) patients had endocrine deficiencies and 1(5.3%) developed progressive bilateral optic atrophy which was present prior to radiotherapy. Neither second malignancy nor neurocognitive dysfunction was reported in our series. CONCLUSION In our study, excellent 5-year overall survival were achieved with chemotherapy followed by reduced whole ventricular radiation. Although ICGCT have favourable cure rates, close attention to long term follow-up with assessment of neurocognitive function and subsequent malignancies is needed.