RTHP-31. A 40-YEAR MULTI-INSTITUTIONAL REVIEW OF INTRACRANIAL GERM CELL TUMORS IN ADOLESCENTS AND YOUNG ADULT
Bibliographic record
Abstract
To determine the outcomes and complications of intracranial germ cell tumors (IGCT) in adolescents and young adults (AYA) according to different therapeutic approaches. One-hundred twelve patients with IGCT aged 15-39 years were managed at either Princess Margaret Cancer Centre or British Columbia Cancer Agency from 1975-2015. The charts of these patients were retrospectively reviewed. Ten-year rates of outcomes and complication rates are reported. Median duration of follow-up was 8.3 years. Ninety-three patients had germinomas, and 19 had non-germinomatous germ cell tumors (NGGCT). Fourteen patients (13%) presented with spinal metastatic disease. Progression-free survival (PFS) was 82% and overall survival (OS) was 88%. For patients with germinoma, PFS was 91% after craniospinal radiation therapy (CSRT) plus chemotherapy (N=11), 100% after whole ventricular RT (WVRT) or tumor bed RT (TBRT) plus chemotherapy (N=20), 89% after CSRT alone (N=44) and 41% after WVRT, whole brain RT or TBRT alone (N=16) (P<0.0005); OS was 91%, 100%, 89%, and 72%, respectively (P=0.085). For patients with NGGCT, PFS was 58% after TBRT plus chemotherapy (N=8) vs. 91% for all others (N=11 [6 treated with CSRT plus chemotherapy, 2 with WVRT plus chemotherapy, 2 with CSRT alone, and 1 with WBRT plus chemotherapy]) (P=0.24); OS was 58% and 100%, respectively (P=0.085). Irradiation-induced complications included a 14% rate of hypopituitarism, 5% seizure disorder, 2% second neoplasms, and 1% visual deterioration. Treatment-induced hearing loss or tinnitus was 10% after RT alone, and 26% after both chemotherapy and RT (N=0.018). Neurocognitive impairment from either disease or treatment was 42% after CSRT or WBRT (N=69), 47% after WVRT (N=23), and 17% after TBRT (N=18). We demonstrate excellent overall outcomes in the largest study of IGCT in AYA to our knowledge. High relapse rates were observed after non-CSRT without chemotherapy in germinoma, and after TBRT plus chemotherapy in NGGCT.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".