Trial reportInternational journal of radiation oncology, biology, physics2022
A Phase 2 Trial of Response-Based Radiation Therapy for Localized Central Nervous System Germ Cell Tumors: Patterns of Failure and Radiation Dosimetry for Nongerminomatous Germ Cell Tumors.
Trial report in International journal of radiation oncology, biology, physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.
- A systematic review and meta-analysis of x-ray therapy versus proton beam therapy for pediatric central nervous system germ cell tumors: TRP-Germinoma 2025.International journal of clinical oncology · 2025Pooled it
- Deep learning segmentation of the cerebral ventricular system and brainstem for pediatric radiotherapy planning.Physics and imaging in radiation oncology · 2026Article
- Risk-Stratified Radiotherapy in Pediatric Cancer.Cancers · 2024Review
- Children's Oncology Group's 2023 blueprint for research: Radiation oncology.Pediatric blood & cancer · 2023Article
- Children's Oncology Group's 2023 blueprint for research: Central nervous system tumors.Pediatric blood & cancer · 2023Article
- Precision based approach to tailoring radiotherapy in the multidisciplinary management of pediatric central nervous system tumors.Journal of the National Cancer Center · 2023Review
- Photon versus proton whole ventricular radiotherapy for non-germinomatous germ cell tumors: A report from the Children's Oncology Group.Pediatric blood & cancer · 2022Article
- Balanced Steady-State Free Precession Techniques Improve Detection of Residual Germ Cell Tumor for Treatment Planning.AJNR. American journal of neuroradiology · 2020Article
- Growing Teratoma Syndrome Arising from a Pineal Mixed Germ Cell Tumor in a 12-Year-Old Boy.Case reports in oncologyArticle
- Toward Systematic Assessment and Improvement of Radiation Therapy Plan Quality of Cooperative Group Trial Submissions: A Report From the Children's Oncology Group.Practical radiation oncologyArticle
Corrections and comments
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Authors and funding
17 authors at 15 institutions in 2 countries.
Funding
Abstract
purposeChildren's Oncology Group study ACNS1123 tested the efficacy of reduced dose and field of radiation therapy (RT) for patients with localized nongerminomatous germ cell tumors (NGGCT) who achieved a complete (CR) or partial response (PR) to chemotherapy. Here, we evaluate the quality of RT and patterns of failure for patients eligible for reduced RT in this phase 2 trial. METHODS AND MATERIALS: Patients with localized NGGCT with CR/PR after induction chemotherapy received reduced RT to 30.6 Gy whole ventricular irradiation and 54 Gy tumor-bed total dose. An atlas was provided to assist with complex RT volumes. Early interventional review was performed for the initial RT plan. Complete RT plans for all patients and images of relapsed patients were centrally reviewed at completion of therapy.
resultsBetween May 2012 and September 2016, 107 eligible patients were enrolled and 66 achieved a CR/PR after induction chemotherapy (± second-look surgery) and were eligible for reduced RT. Median follow-up was 4.4 years. Median age was 11.0 years (3.7-21.6), and 75% were male. Progression-free survival and overall survival at 4 years were 87.9% ± 4.0% and 92.4% ± 3.3% for 66 evaluable patients, respectively. Eight patients relapsed: 6 with isolated spinal relapse and 2 with disease in the brain and spine. After central review, 62 (94%) patients had RT targets contoured and dose delivered per protocol. None of the patients with deviations (n = 4) have progressed.
conclusionsPatterns of failure suggest the spine is at risk for recurrence for patients with localized NGGCT who receive reduced RT after a CR/PR to induction chemotherapy. Although survival data are encouraging, the pattern of failure has influenced the next prospective trial design. RT compliance was excellent despite complexity of radiation volumes, suggesting that providing visual guidance in the form of an online atlas contributes to higher quality RT plans.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.