Central Nervous System Germ Cell Tumors (CNS GCTs)

Germ cell tumors of the central nervous system are rare malignancies and comprise a variety of pathologies. Germinoma accounts for approximately 60–70% and non-germinomatous germ cell tumors (NGGCTs) for 30–40% of CNS GCT. While discrepancies in diagnostic management and treatment choices remain, the value of tumor markers at the time of diagnosis and during treatment is well recognized and has prompted in many parts of the world minimally invasive and less morbid neurosurgical approaches. Overall survival (OS) significantly improved when chemotherapy was introduced and combined with irradiation for secreting NGGCT patients. Adjuvant chemotherapy did not translate into superior OS when compared to irradiation-only approaches for germinoma patients; however, the combined approach allowed radiotherapy dose and volume reductions. Current national and international cooperative studies are directing their efforts towards treatment strategies that maintain high cure rates while reducing treatment-related morbidity to improve long-term quality of life.