An intracranial germinoma is a disembryogenetic tumor, identical in structure to a testicular seminoma. This type of neoplasm is most often found in adolescence. This accounts for about 5% of all malignant tumors in children. Doctors in Germany successfully cure 90% of patients. The main method of treatment is radiation therapy. Some patients also require surgery and chemotherapy.
Content
- Principles of treatment
- Surgical treatment
- Radiation therapy
Doctors most often use radiation therapy in combination with chemotherapy. In rare cases, patients receive radiation therapy alone. Tumor removal surgery is usually not required, but patients with hydrocephalus require a surgical procedure to eliminate CSF hypertension.
You can undergo your treatment in one of the following hospitals: University Hospital Rechts der Isar Munich, University Hospital Charite Berlin, or University Hospital Freiburg.
The specialists of the Booking Health company will take care of the organization of your trip abroad. They will help you to select a clinic and a doctor, provide information on the most successful types of treatment, help you to quickly make an appointment at a clinic, take care of a visa and paperwork, provide an invitation for treatment, book airline tickets and transfers, provide interpreting services and medical insurance, provide interpreting services and help with any other issues.
Principles of treatment
Treatment options for an intracranial germinoma include the following:
- radiation therapy only;
- radiation therapy and chemotherapy, but smaller doses of radiation are used;
- chemotherapy as a standalone method is very rare, only if there are contraindications to radiation therapy (this approach is associated with a higher chance of recurrence).
Operations are performed mainly to eliminate hydrocephalus. Sometimes doctors shrink the tumor with chemotherapy and then remove it surgically. However, this approach is not common, since an intracranial germinoma can be cured without surgery.
Which method of treatment will be chosen depends on a patient's age, the stage of the oncological disease, and experience of a medical center.
Radiation therapy alone, without chemotherapy, is quite effective. But the problem is that doctors have to use higher doses of radiation and irradiate more brain tissue. This has a bad effect on a child's mental development, and complications may occur in the distant future.
Therefore, doctors often combine two treatment methods: chemotherapy and radiation therapy. Patients are first treated with drugs. The tumor shrinkage will be followed by its destruction with radiation. The required radiation dose is half as much, so this treatment is safer.
Surgical treatment
Some patients require surgery. Doctors perform interventions to eliminate increased intracranial pressure:
- endoscopic third ventriculostomy (ETV) is a minimally invasive operation with a short rehabilitation period, which involves creating an opening in the floor of the third ventricle for the CSF outflow;
- external ventricular drainage is a placement of a drainage system to remove fluid from the lateral ventricle into the external environment.
It is possible to conduct a tumor biopsy: open, stereotactic or endoscopic. However, a radical germinoma resection is not required, as radiation therapy can cure the disease.
Radiation therapy
Chemotherapy alone can cure two-thirds of patients. Nonetheless, the remaining third will relapse without radiation therapy. Therefore, radiation therapy is considered an obligatory stage of treatment. Sometimes this is the only method a patient needs: doctors can sometimes destroy the tumor with radiation without chemotherapy in teenagers and young adults.
Although radiation therapy is very effective, this treatment option is not safe. Doctors inevitably irradiate healthy brain tissue. The hypothalamus is often damaged, so the production of hormones is disrupted. If the radiation area is large, a zone of radiation necrosis may occur. For children, the consequences of radiotherapy can be an intellectual disability and neurological deficits.
However, the risk of complications can be reduced to a minimum. To do this, one should:
- use new radiation therapy options on state-of-the-art equipment;
- undergo treatment in specialized Cancer Centers with extensive experience in treating tumors of the central nervous system in children.
Healthcare professionals abroad use stereotactic radiotherapy and radiosurgery with Gamma Knife and Cyberknife devices. Radiation is delivered to the tumor very accurately from different angles.
A Gamma Knife involves the use of a helmet-like device. There are over 200 stationary sources of radiation inside. The latest versions of this system have fewer radiation sources, but they can move. In any case, the essence of the irradiation method is that the rays enter the brain from different directions, but converge on the tumor. As a result, a germinoma receives a large dose of radiation, and each piece of tissue through which the radiation passes is slightly irradiated. With this approach, the risk of complications is much lower.
In addition, there are six proton therapy centers in Germany. This is the safest form of radiation for brain tumors in children. Protons emit radiation predominantly within the target, with little or no irradiation of the tissue through which they pass. As a result, radiation becomes even safer.
You are welcome to use the Booking Health service to undergo your diagnostics and treatment of intracranial germinoma in Germany. On our website, you can find out prices, compare the cost of procedures and operations in different hospitals and make your treatment appointment at the best price. The Booking Health specialists will help you to find the most suitable clinics in Germany and organize your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
National Library of Medicine
MedlinePlus
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