Radiotherapy and chemotherapy plus radiation in the treatment of patients with pure intracranial germinoma: A meta-analysis.

OBJECTIVE: To evaluate the efficiency of radiotherapy (RT) only and chemotherapy plus radiotherapy (CRT) strategy in the treatment of pure intracranial germinoma.

METHODS: We searched PUBMED, EMBASE, Medline and Cochrane library up to May 2016 for studies that enrolled patients with pure intracranial germinoma receiving either RT only or CRT treatment as their first-line treatment. The meta-analysis was conducted on the overall survival rate (OS) and disease free survival (DFS) at 3years and 5years. The outcomes were pooled using a random-effect model.

RESULTS: The final search included 15 studies with 310 patients. The pooled 3-year OS (97% vs. 94%, p=.000) and 3-year DFS (96% vs. 93%, p=0.043) of CRT group was significantly higher than that of RT only group. However, at 5years, the OS was 94% in RT only group and 92% in the combined group (p=0.29) . For DFS, the RT only group was higher than the combined group (94% vs.89%, p=.000).

CONCLUSIONS: Both RT and CRT for intracranial pure germinoma gain satisfying outcomes, and the CRT strategy has a higher overall survival rate and disease free survival rate at 3years than RT regimen. At 5years in the postoperative period, the advantage of survival rates for CRT is eliminated or even reversed. For patients with pure intracranial germinoma, especially those with acute and severer condition and poorer prognosis, CRT strategy would be a better choice.