A Phase 2 Trial of Response-Based Radiation Therapy for Localized Central Nervous System Germ Cell Tumors: Patterns of Failure and Radiation Dosimetry for Nongerminomatous Germ Cell Tumors

Murphy ES, Dhall G, Fangusaro J, Bartels U, Fouladi M, Shaw D, Khatua S, Hughes CW, Panigraphy A, Ioakeim-Ioannidou M, Souweidane M, Morris D, Gajjar A, Wu S, Onar-Thomas A, Haas-Kogan DA, MacDonald SM. A Phase 2 Trial of Response-Based Radiation Therapy for Localized Central Nervous System Germ Cell Tumors: Patterns of Failure and Radiation Dosimetry for Nongerminomatous Germ Cell Tumors. Int J Radiat Oncol Biol Phys. 2022 May 1;113(1):143-151. doi: 10.1016/j.ijrobp.2021.12.166. Epub 2022 Jan 4. PubMed PMID: 34990779; PubMed Central PMCID: PMC9645815.

Children’s Oncology Group study ACNS1123 tested the efficacy of reduced dose and field of radiation therapy (RT) for patients with localized nongerminomatous germ cell tumors (NGGCT) who achieved a complete (CR) or partial response (PR) to chemotherapy. Here, we evaluate the quality of RT and patterns of failure for patients eligible for reduced RT in this phase 2 trial. Patients with localized NGGCT with CR/PR after induction chemotherapy received reduced RT to 30.6 Gy whole ventricular irradiation and 54 Gy tumor-bed total dose. An atlas was provided to assist with complex RT volumes. Early interventional review was performed for the initial RT plan. Complete RT plans for all patients and images of relapsed patients were centrally reviewed at completion of therapy.