Treatment Outcomes and Prognostic Factors of Intracranial Germ Cell Tumors: A Single Institution Retrospective Study

Abstract

Background This study analyzed the epidemiology and treatment outcomes of germ cell tumor patients at a single institution. Methods A retrospective analysis was conducted on intracranial germ cell tumor (iGCT) patients treated at a single tertiary hospital from 2004 to 2019. Patients were categorized based on treatment modality: Korean Society for Pediatric Neuro-Oncology (KSPNO) protocol or bleomycin, etopo-side, and cisplatin with radiation therapy. Results Forty-nine iGCT patients treated with combined chemotherapy and radiotherapy were analyzed. The median age was 19 years (range: 6–40), with a median follow-up duration of 148.0 months (range: 10.5–265.5). Tumors were most common in the pineal gland (51.0%). Although no significant differences in outcomes were observed between treatment modalities, outcomes varied signifi-cantly by pathological type. The 10-year progression-free survival rates for germinoma and non-germino-matous germ cell tumors (NGGCTs) were 88.1% and 32.7%, respectively (p=0.003), while the 10-year overall survival rates were 92.9% and 67.5%, respectively (p<0.001). Fourteen patients experienced CTCAE (Common Terminology Criteria for Adverse Events) grade ≥3 adverse events, with one event-related death. Conclusion Pure germinoma demonstrated higher survival and lower recurrence rates compared to NGGCT. The KSPNO protocol appears to be an acceptable and safe treatment option for iGCT pa-tients. Further multi-institutional studies with larger cohorts are warranted. © 2025 The Korean Brain Tumor Society, The Korean Society for Neuro-Oncology, and The Korean Society for Pediatric Neuro-Oncology.