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

•Comparison of the effect of RT and CRT for intracranial pure germinoma were limited.•CRT strategy had higher overall survival rate and disease-free rate than RT only strategy at 3 years.•The advantage of CRT strategy was eliminated or even reversed at 5 years.•CRT is the optimal choice for patients in severe conditions and poor prognosis.

ObjectiveTo evaluate the efficiency of radiotherapy (RT) only and chemotherapy plus radiotherapy (CRT) strategy in the treatment of pure intracranial germinoma.MethodsWe 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 3 years and 5 years. The outcomes were pooled using a random-effect model.ResultsThe 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 5 years, 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).ConclusionsBoth 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 3 years than RT regimen. At 5 years 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.