Application of diagnostic chemotherapy in the diagnosis and treatment of intracranial germinoma

Objective To explore and evaluate the feasibility and clinical significance of diagnostic chemotherapy in the diagnosis and treatment of intracranial germinoma.Methods Diagnostic chemotherapy was applied in 13 cases with germinoma related clinical manifestation and normal level of serum tumor marker,but difficulty or high risk in acquiring histopathologic sample.Only one course of standard cisplatin plus etoposide protocol was given,and CT or MRI was performed in 10-14 days after chemotherapy.The therapeutic effect was evaluated according to the WHO standard for chemotherapy of solid tumor.The reliability of diagnostic chemotherapy was also verified by long-term effect.Results 2 cases of complete response,9 cases of partial response and 2 cases of no response were observed.The cases of complete response and partial response underwent radiotherapy in the following treatment,and the result supported the diagnosis of germinoma.One of the two no-response cases received surgery and was proved to be a grade-Ⅱ glioma.The other one case of no response underwent no further treatment,and 6-month followup MRI demonstrated a cavernoma.Conclusions Diagnostic chemotherapy could be applied to identify germinoma and non-germinoma,and to confirm the diagnosis in case of high possibility of germinoma. Key words: Germinoma; Diagnostic ;  Chemotherapy;  Central nervous system