Radiation therapy to the entire brain and often to the spinal cord is part of the standard therapy for germ cell tumors of the central nervous system (CNS). However, this treatment can result in later side effects, such as learning difficulties, problems performing daily activities, and impaired growth. Doctors are therefore seeking other effective ways to treat these cancers that are associated with fewer side effects.
In this Children’s Oncology Group study, researchers are assessing the combination of chemotherapy and limited radiation therapy in children and adolescents with localized germ cell tumors of the CNS. Patients with germinoma tumors of the CNS will first receive the chemotherapy drugs carboplatin and etoposide. Patients who respond well to the chemotherapy will then receive a lower dose of radiation to the tumor site and to the fluid-filled space of the brain (ventricles), using an approach called whole ventricular irradiation (WVI).
Patients with non-germinoma CNS germ cell tumors will first receive induction chemotherapy with carboplatin and etoposide, followed by ifosfamide and etoposide. Those who respond well to induction chemotherapy will then receive WVI.
In addition to assessing treatment effectiveness, researchers will also evaluate the neuropsychological and behavioral function of patients treated in this study.