Intracranial Germinoma: Successful Management by Chemotherapy and Intensity Modulated Radiation Therapy

Abstract

Introduction: Germinomas are malignant intracranial germ cell tumors, usually found in pineal region. These tumors are exquisitely sensitive to radiation. Whole ventricle radiation (RT) with a boost field to the primary tumor is the standard treatment for localized germinomas. RapidArc radiotherapy is considered an excellent technological advance that shows great potential for producing highly conformal doses to treatment volumes. Case report: We present a case of intracranial germinoma who achieved a partial remission after four courses of chemotherapy induction. The patient received whole ventricular radiation therapy followed by a boost to the tumor and its margin to a total dose of 40 Gy using RapidArc radiotherapy over the course of 5 weeks. Any toxicity has been noted during the treatment. Early post treatment imaging showed a complete response. Conclusion: This case demonstrates a successful management of localized intracranial germinoma by RapidArc radiotherapy that allowed a highly conformal volumetric dose distribution with optimal sparing of surrounding areas of the brain.