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Risk of second tumor in intracranial germinoma patients treated with radiation therapy: the Johns Hopkins experience

  • Clinical study - patient study
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Abstract

Background We reviewed the risk of second tumor (ST), both malignant and benign, in germinoma survivors followed at the Johns Hopkins Hospital (JHH). Methods Between 1977 and 2002, 27 patients with intracranial germinoma were treated with radiation therapy (RT). In the presence of competing events, a cumulative incidence function of ST was estimated using the minimal time interval from the date of diagnosis to the date of ST, date of death, or date of last follow-up. Results Five patients (18%) developed a ST of which 4 (15%) were malignant. One developed a benign falcine meningioma. The cumulative incidence of ST was 9% at 11 years (95% CI, 0–22%). Conclusions The relative contributions of RT and patient susceptibility to a ST cannot be determined but suggests the need for long-term surveillance, including testicular self-exams in male germinoma survivors. Current trials of chemotherapy and reduced RT dose and volume offer the prospect of a lower risk of treatment-induced ST.

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References

  1. Maity A, Shu H-KG, Janss A, Belasco JB, Rorke L, Phillips PC, Sutton LN, Goldwein JW (2004) Craniospinal radiation in the treatment of biopsy-proven intracranial germinomas: twenty-five years’ experience in a single center. Int J Radiat Oncol Biol Phys 58:1165–1170

    PubMed  Google Scholar 

  2. Bamberg M, Kortmann RD, Calaminus G, Becker G, Meisner C, Harms D, Gobel U (1999) Radiation therapy for intracranial germinoma: results of the German cooperative prospective trials MAKEI 83/86/89. J Clin Oncol 17:2585–2592

    PubMed  CAS  Google Scholar 

  3. Hardenbergh PH, Golden J, Billet A, Scott RM, Shrieve DC, Silver B, Loeffler JS, Tarbell NJ (1997) Intracranial germinoma: the case for lower dose radiation therapy. Int J Radiat Oncol Biol Phys 39:419–426

    PubMed  CAS  Google Scholar 

  4. Balmaceda C, Heller G, Rosenblum M, Diez B, Villablanca JG, Kellie S, Maher P, Vlamis V, Walker RW, Leibel S, Finlay JL (1996) Chemotherapy without irradiation—a novel approach for newly diagnosed CNS germ cell tumors: results of an international cooperative trial. The First International Central Nervous System Germ Cell Tumor Study. J Clin Oncol 14:2908–2915

    PubMed  CAS  Google Scholar 

  5. Kellie SJ, Boyce H, Dunkel IJ, Diez B, Rosenblum M, Brualdi L, Finlay JL (2004) Primary chemotherapy for intracranial nongerminomatous germ cell tumors: results of the second international CNS germ cell study group protocol. J Clin Oncol 22:846–853

    Article  PubMed  CAS  Google Scholar 

  6. Baranzelli MC, Patte C, Bouffet E, Couanet D, Habrand JL, Portas M, Lejars O, Lutz P, Le Gall E, Kalifa C (1997) Nonmetastatic intracranial germinoma: the experience of the French Society of Pediatric Oncology. Cancer 80:1792–1797

    Article  PubMed  CAS  Google Scholar 

  7. Sawamura Y, Shirato H, Ikeda J, Tada M, Ishii N, Kato T, Abe H, Fujieda K (1998) Induction chemotherapy followed by reduced-volume radiation therapy for newly diagnosed central nervous system germinoma. J Neurosurg 88:66–72

    Article  PubMed  CAS  Google Scholar 

  8. Merchant TE, Sherwood SH, Mulhern RK, Rose SR, Thompson SJ, Sanford RA, Kun LE (2000) CNS germinoma: disease control and long-term functional outcome for 12 children treated with craniospinal irradiation. Int J Radiat Oncol Biol Phys 46:1171–1176

    Article  PubMed  CAS  Google Scholar 

  9. Neglia JP, Friedman DL, Yasui Y, Mertens AC, Hammond S, Stovall M, Donaldson SS, Meadows AT, Robison LL (2001) Second malignant neoplasms in five-year survivors of childhood cancer: childhood cancer survivor study. J Natl Cancer Inst 93:618–629

    Article  PubMed  CAS  Google Scholar 

  10. MacArthur AC, Spinelli JJ, Rogers PC, Goddard KJ, Phillips N, McBride ML (2007) Risk of a second malignant neoplasm among 5-year survivors of cancer in childhood and adolescence in British Columbia, Canada. Pediatr Blood Cancer 48:453–459

    Article  PubMed  Google Scholar 

  11. Kalbfeish JD, Prentice RL (1980) The statistical analysis of failure time data. Wiley, New York

    Google Scholar 

  12. Fine JP, Gray RJ (1999) A proportional hazards model for the subdistribution of a competing risk. JASA 94:496–506

    Google Scholar 

  13. Sawamura Y, Ikeda J, Shirato H, Tada M, Abe H (1998) Germ cell tumours of the central nervous system: treatment consideration based on 111 cases and their long-term clinical outcomes. Eur J Cancer 34:104–110

    Article  PubMed  CAS  Google Scholar 

  14. Peterson KM, Shao C, McCarter R, MacDonald TJ, Byrne J (2006) An analysis of SEER data of increasing risk of secondary malignant neoplasms among long-term survivors of childhood brain tumors [see comment]. Pediatr Blood Cancer 47:83–88

    Article  PubMed  Google Scholar 

  15. Daniel C, Fizazi K, Culine S, Zelek L, Wibault P, Theodore C (2001) Metachronous gonadal and extragonadal primaries, or late relapse of germ cell tumor? Urol Oncol 6:49–52

    Article  PubMed  CAS  Google Scholar 

  16. Goldstein AM, Yuen J, Tucker MA (1997) Second cancers after medulloblastoma: population-based results from the United States and Sweden. Cancer Causes Control 8:865–871

    Article  PubMed  CAS  Google Scholar 

  17. Duffner PK, Krischer JP, Horowitz ME, Cohen ME, Burger PC, Friedman HS, Kun LE (1998) Second malignancies in young children with primary brain tumors following treatment with prolonged postoperative chemotherapy and delayed irradiation: a Pediatric Oncology Group study [see comment]. Ann Neurol 44:313–316

    Article  PubMed  CAS  Google Scholar 

  18. Morris EB, Gajjar A, Okuma JO, Yasui Y, Wallace D, Kun LE, Merchant TE, Fouladi M, Broniscer A, Robison LL, Hudson MM (2007) Survival and late mortality in long-term survivors of pediatric CNS tumors. J Clin Oncol 25:1532–1538

    Article  PubMed  Google Scholar 

  19. Witherby SM, Butnor KJ, Grunberg SM, Witherby SM, Butnor KJ, Grunberg SM (2007) Malignant mesothelioma following thoracic radiotherapy for lung cancer. Lung Cancer 57:410–413

    Article  PubMed  Google Scholar 

  20. Brown LM, Howard RA, Travis LB, Brown LM, Howard RA, Travis LB (2006) The risk of secondary malignancies over 30 years after the treatment of non-Hodgkin lymphoma [comment]. Cancer 107:2741–2742 author reply 2742

    Article  PubMed  Google Scholar 

  21. Travis LB, Fossa SD, Schonfeld SJ, McMaster ML, Lynch CF, Storm H, Hall P, Holowaty E, Andersen A, Pukkala E, Andersson M, Kaijser M, Gospodarowicz M, Joensuu T, Cohen RJ, Boice JD Jr, Dores GM, Gilbert ES, Travis LB, Fossa SD, Schonfeld SJ, McMaster ML, Lynch CF, Storm H, Hall P, Holowaty E, Andersen A, Pukkala E, Andersson M, Kaijser M, Gospodarowicz M, Joensuu T, Cohen RJ, Boice JD Jr, Dores GM, Gilbert ES (2005) Second cancers among 40, 576 testicular cancer patients focus on long-term survivors. J Natl Cancer Inst 97:1354–1365

    Article  PubMed  Google Scholar 

  22. Das P, Ng AK, Stevenson MA, Mauch PM (2005) Clinical course of thoracic cancers in Hodgkin’s disease survivors. Ann Oncol 16:793–797

    Article  PubMed  CAS  Google Scholar 

  23. Sato F, Yamazaki H, Ataka K, Mashima I, Suzuki K, Takahashi T, Umezu H, Gejyo F (2000) Malignant peritoneal mesothelioma associated with deep vein thrombosis following radiotherapy for seminoma of the testis. Intern Med 39:920–924

    Article  PubMed  CAS  Google Scholar 

  24. Strojan P, Popovi M, Jereb B (2000) Secondary intracranial meningiomas after high-dose cranial irradiation report of five cases and review of the literature. Int J Radiat Oncol Biol Phys 48:65–73

    Article  PubMed  CAS  Google Scholar 

  25. Ron E, Modan B, Boice JD Jr, Alfandry E, Stovall M, Chetrit A (1988) Katz L Tumors of the brain and nervous system after radiotherapy in childhood. N Eng J Med 319:1033–1039

    CAS  Google Scholar 

  26. Goshen Y, Stark B, Kornreich L, Michowiz S, Feinmesser M, Yaniv I (2007) High incidence of meningioma in cranial irradiated survivors of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 49:294–297

    Article  PubMed  Google Scholar 

  27. Bosl GJ, Dmitrovsky E, Reuter VE, Samaniego F, Rodriguez E, Geller NL, Chaganti RS (1989) Isochromosome of the short arm of chromosome 12 clinically useful markers for male germ cell tumors. J Natl Cancer Inst 81:1874–1878

    Article  PubMed  CAS  Google Scholar 

  28. Oosterhuis JW, Castedo SM, de Jong B, Conrelisse CJ, Dam A, Sleijfer DT, Schraffordt Koops H (1989) Ploidy of primary germ cell tumors of the testis Pathologenetic and clinical relevance. Lab Invest 60:14–21

    PubMed  CAS  Google Scholar 

  29. Guerin S, Hawkins M, Shamsaldin A, Guibout C, Diallo I, Oberlin O, Brugieres L, de Vathaire F (2007) Treatment-adjusted predisposition to second malignant neoplasms after a solid cancer in childhood: a case-control study. J Clin Oncol 25:2833–2839

    Article  PubMed  CAS  Google Scholar 

  30. Maity A, Shu H-KG, Judkins AR, Fisher MJ, Dwyer-Joyce LEA, Vaughn DJ (2004) Testicular seminoma 16 years after treatment for CNS germinoma. J Neurooncol 70:83–85

    Article  PubMed  Google Scholar 

  31. Haas-Kogan DA, Missett BT, Wara WM, Donaldson SS, Lamborn KR, Prados MD, Fisher PG, Huhn SL, Fisch BM, Berger MS, Le QT (2003) Radiation therapy for intracranial germ cell tumors. Int J Radiat Oncol Biol Phys 56:511–518 [erratum appears in Int J Radiat Oncol Biol Phys. 2003 Sep 1;57(1):306]

    Article  PubMed  Google Scholar 

  32. Shikama N, Ogawa K, Tanaka S, Toita T, Nakamura K, Uno T, Ohnishi H, Itami J, Tada T, Saeki N (2005) Lack of benefit of spinal irradiation in the primary treatment of intracranial germinoma: a multiinstitutional, retrospective review of 180 patients. Cancer 104:126–134

    Article  PubMed  Google Scholar 

  33. Calaminus G, Bamberg M, Harms D, Jurgens H, Kortmann RD, Sorensen N, Wiestler OD, Gobel U (2005) AFP/beta-HCG secreting CNS germ cell tumors: long-term outcome with respect to initial symptoms and primary tumor resection Results of the cooperative trial MAKEI 89. Neuropediatrics 36:71–77

    Article  PubMed  CAS  Google Scholar 

  34. Strojan P, Zadravec LZ, Anzic J, Korenjak R, Jereb B (2006) The role of radiotherapy in the treatment of childhood intracranial germinoma: long-term survival and late effects [see comment]. Pediatr Blood Cancer 47:77–82

    Article  PubMed  Google Scholar 

  35. Hupperets PS, Defesche HF, de Bruijckere LM, Twijnstra A (1999) The role of chemotherapy in intracranial germinoma: a case report. Ann Oncol 10:723–726

    Article  PubMed  CAS  Google Scholar 

  36. Peat DS, Trowell JE (1994) Testicular seminoma in a patient with pineal germinoma. J Clin Pathol 47:771–772

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Radiation Oncology, Cancer Institute of New Jersey, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ, USA

    Salma K. Jabbour

  2. Division of Biostatistics, Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Zhe Zhang

  3. Washington Hospital Center, Washington, DC, USA

    Dagmar Arnold

  4. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, CRB II, Room 4 M 05, 1550 Orleans St, Baltimore, MD, 21231, USA

    Moody D. Wharam

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  1. Salma K. Jabbour
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  2. Zhe Zhang
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  4. Moody D. Wharam
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Correspondence to Moody D. Wharam.

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Jabbour, S.K., 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, 227–232 (2009). https://doi.org/10.1007/s11060-008-9703-5

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  • DOI: https://doi.org/10.1007/s11060-008-9703-5

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