BRAIN METASTASES OF GERM CELL TUMORS. THE RUSSIAN CANCER RESEARCH CENTER'S EXPERIENCE

This paper analyzes the experience in treating 20 patients with nonseminomatous germ cell tumors metastasizing to the brain. It presents brain metastasis-associated factors: multiple lung metastases; IGCCCG poor prognosis; and a baseline human chorionic gonadotropin level of > 50000 mIU/ml. The authors have identified a group to be screened for brain metastasis, which includes patients with intermediate/poor prognosis and multiple lung metastases. Long-term survival was achieved in 45 % of patients with baseline brain damage and in 22 % of those with metastases revealed after first-line chemotherapy. The positive prognostic factors associated with long-term survival were a single brain lesion, no neurological symptoms, and achievement of clinical complete personse in the brain.

1. Статистика злокачественных новообразований в России и странах СНГ в 2009 г. Под ред. М. И. Давыдова, Е. М. Аксель. Вест РОНЦ им. Н. Н. Блохина 2011;22(3), прил. 1.

2. Ferlay J., Parkin D. M., Steliarova-Foucher Steliarova-Foucher E. Estimates of cancer incidence and mortality in Europe in 2008. Eur J Cancer 2010;6:765–81.

3. Williams S. D., Einhorn L. H. Brain metastases in disseminated germinal neoplasms. Cancer 1979;44:1514–6.

4. Mead G. M., Stenning S. P., Parkinson M. C. et al. The Second Medical Research Council study of prognostic factors in nonseminomatous germ cell tumors. Medical Research Council Testicular Tumour Working Party. J Clin Oncol 1992;10:85–94.

5. International Germ Cell Cancer Collaborative Group. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol 1997;15:594–603.

6. Rustin G. J., Newlands E. S., Bagshawe K. D. et al. Successful management of metastatic and primary germ cell tumors. Cancer 1986;57:2108–13.

7. Kaye S. B., Bagshawe K. D., McElwain T. J., Peckham M. J. Brain metastases in malignant teratoma: a review of four years» experience and an assessment of the role of tumour markers. Br J Cancer 1979;39:217–23.

8. Oechsle K., Kollmannsberger C., Honecker F. et al. Cerebral metastases in nonseminomatous germ cell tumour patients undergoing primary high-dose chemotherapy. Eur J Cancer 2008;44(12):1663–9..

9. Nonomura N., Nagahara A., Oka D. et al. Brain metastases from testicular germ cell tumors: A retrospective analysis. Int J Urology 2009;16:887–93.

10. Martinez-Cedillo J. Treatment of brain metastases in patients with testicular germ cell tumors. J Clin Oncol 29:2011 (suppl), abstr e15155.

11. Boyle H. J., Droz J., Jouanneau E., Flechon A. Management of brain metastases from germ cell tumours. J Clin Oncol 26:2008 (suppl); abstr 16076.

12. Fosså S. D., Bokemeyer C., Gerl A. et al. Treatment outcome of patients with brain metastases from malignant germ cell tumors. Cancer 1999;15;85 (4):988–97.

13. Calaminus G., Bamberg M., Jürgens H. et al. Impact of surgery, chemotherapy and irradiation on long term outcome of intracranial malignant non-germinomatous germ cell tumors: results of the German Cooperative Trial MAKEI 89. Klin Padiatr 2004;216(3):141–9.

14. Doyle D. M., Einhorn L. H. Delayed effects of whole brain radiotherapy in germ cell tumor patients with central nervous system metastases. Int J Radiat Oncol Biol Phys 2008;70(5):1361–4.