A Study On The Effect Of Integrated Therapy On Children's Intracranial NGMGCTs

Objective: To investigate the clinical characteristics,diagnosis and treatment,prognosis of intracranial Non-germinomatous malignant germ cell tumors(NGMGCTs)in children.Methods: From August 2010 to January 2018,21 cases of intracranial NGMGCTs were diagnosed by our hospital according to the results of alpha fetoprotein(AFP>25 ng/ml),human chorionic gonadotropin(HCG>50 IU/L)and imaging date.The clinical characteristics,curative effect and prognosis of this group were analyzed retrospectively.Results: There were 21 patients with intracranial NGMGCTs followed up,Until December 2019,all of them were treated with integrated therapy which includes neoadjuvant chemotherapy,radiotherapy,consolidation chemotherapy and second-stage exploration when necessary.Only two patients progressed in the course of treatment,one of them could not receive radiotherapy because was diagnosed in 8 months old.The overall response rate was 90.48%(19 / 21),clinical benefit rate was 95.24%(20 / 21),median follow-up time was 42.00 months,and the longest progression free survival was 83 months,the shortest progression free survival was 7 months,the 2-year overall survival rate was 85.71%,and the 3-year overall survival rate was 61.90%.Conclusion: 1)For the patients whose serum or cerebrospinal fluid tumor markers reach the diagnostic threshold AFP>25ng/ml and(or)HCG>50IU/L,the intracranial NGMGCTs can be clinically diagnosed according to the imaging data.2)Less than three years old or AFP >1000ng/mL may be independent risk factors for poor prognosis;3)Children with immature/mature teratoma components mainly considered,while effective adjuvant therapy is provided,Close follow-up and,if necessary,surgical resection are one of the ways to improve the prognosis;4)Neoadjuvant chemotherapy,radiotherapy and consolidation chemotherapy of "sandwich" integrated therapy is a recommended treatment for children with intracranial NGMGCTs.