Impacts of Elevated Level of hCG in Serum on Clinical Course and Radiotherapy Results in the Histology-confirmed Intracranial Germinomas

Abstract

Th e prognosis of intracranial germinoma producing the human chorionic gonadotropin (hCG) is controversial due to limitedinformation. We undertook a retrospective analysis to determine whether this type of tumor has similar clinical course and prognosis tohC G non-secreting germinoma. Thirty-one histologically con ® rme d intracranial germinoma patients who had pretreatment hCGexamination in seru m:CSF were treated with radiotherapy between 198 0 an d 1996. hC G leve l wa s measured by immunoradioassay ofbsubunit of hCG. Six patients had elevated seru m hCG level s an d wer e de® ne d as having hCG secreting germinoma. All except thre epatients received craniospinal axi s irradiation. The follow-up ranged from 19± 175 months with a median of 63 months. hC G secretinggerminoma accounted for 19% of intracranial germinoma cases. Elevated hC G levels ranged from 39 ± 260 IU:l in serum. No differencewas foun d between hCG non-secreting germinoma and hCG secreting germinoma in terms of patient or treatment characteristics. Therewas no recurrence among the six hCG secreting germinoma patients. Th e 5-year overall and disease-free survival rate s wer e 96 % forpatients with hCG non-secreting germinomas an d 100 % for the patients wit h hC G secreting germinomas. The survival difference was notsigni® can t (p¾0.59). Ou r results suggest that elevated leve l of hCG di d not result in any differences in the clinical characteristics orsurvival after radical radiotherapy in histologically con® rmed intracranial germinoma.