Vinblastine monotherapy induction prior to radiotherapy for patients with intracranial germinoma during the COVID-19 pandemic.
Pediatr Blood Cancer
; 69(1): e29359, 2022 01.
Article
in English
| MEDLINE | ID: covidwho-1406146
ABSTRACT
BACKGROUND:
Patients with localized intracranial germinoma have excellent survival. Reducing treatment burden and long-term sequelae is a priority. Intensive inpatient chemotherapy (e.g., carboPEI = carboplatin/etoposide/ifosfamide) has been effectively employed to reduce radiotherapy treatment volume/dose. Outpatient-based carboplatin monotherapy is associated with excellent outcomes in metastatic testicular seminoma (an identical pathology), and successful vinblastine monotherapy induction (with 77% tumor volume reduction after just two weekly vinblastine doses) has recently been reported in an intracranial germinoma patient.METHODS:
Adapted UK guidelines for germ cell tumor management were distributed during the COVID-19 pandemic, including nonstandard treatment options to reduce hospital visits and/or admissions. This included vinblastine monotherapy for intracranial germinoma (6 mg/m2 intravenously, or 4 mg/m2 for moderate count suppression, delivered weekly). We describe two such patients treated using this approach.RESULTS:
A 30-year-old male with a localized pineal tumor received 12-week vinblastine induction, with >60% volume reduction, prior to definitive radiotherapy. A 12-year-old female with a metastatic suprasellar tumor and progression at all sites of disease whilst awaiting proton radiotherapy received two vinblastine doses with good early response, including 36% primary tumor volume reduction. The patients tolerated vinblastine well.CONCLUSION:
Patients with intracranial germinoma have excellent outcomes, and reduction of late effects remains a priority. The description of vinblastine monotherapy in these intracranial germinoma patients warrants further exploration.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vinblastine
/
Brain Neoplasms
/
Germinoma
/
Neoplasms, Germ Cell and Embryonal
Type of study:
Case report
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Adult
/
Child
/
Female
/
Humans
/
Male
Language:
English
Journal:
Pediatr Blood Cancer
Journal subject:
Hematology
/
Neoplasms
/
Pediatrics
Year:
2022
Document Type:
Article
Affiliation country:
Pbc.29359
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