GC-11: PRELIMINARY RESULTS OF A CNSGCT BRAZILIAN PROTOCOL CONSORTIUM

INTRODUCTION: Primary central nervous system germ cell tumors (CNSGCT) accounts for 2-3% of brain tumors in children/adolescents in western hemisphere being classified according to histological components as germinomas and non-germinomatous germ cell tumors (NGGCTs). OBJECTIVE: To evaluate the preliminary results of a CNSGCT protocol consortium. MATERIAL/METHODS: Since 2013, 20 patients with histological and/or tumor markers (TM) diagnosis of germinoma +/- HCG < 200mIU/ml (N = 17) and NGGCTs (N = 3), received 4-6 cycles of carboplatin/etoposide/cytoxan, followed by 18Gy of ventricular field irradiation (VFI) and primary site(s) boost. Autologous bone marrow transplant (ABMT) was conducted for NGGCTs low responders after initial chemotherapy. RESULTS: The mean age was 13 years, fifteen were male. Diagnosis was made by TM (N = 3), surgery (N = 12) or both (N = 5). Primary tumor location was pineal (N = 9), suprasellar (N = 5) and bifocal (N = 6), five had ventricular/intramedullary spread. Second-look surgery occurred in 3 cases. For the germinoma group 13 patients achieved complete response after 4 cycles of carbo/etoposide. The 3 NGGCT patients showed partial response after 4 cycles, 2 with negative TM. One was submitted to ABMT. Radiotherapy was performed as described except in 2 cases. No recurrence to date. One patient died of endocrinological complications. Toxicity was mostly G3/4 neutropenia and thrombocytopenia, in the NGGCT group with cytoxan and all patients for at least 1 cycle using carboplatin. At a mean follow-up of 19.6 months (4-41 months), the overall and event-free survival was 93%. CONCLUSION: The reducing dose of VFI seems to be effective. Further follow-up is warranted to better assess efficacy of this treatment including the low responder strategy.