Treatment of XXXX of the pineal region.

@entity1 @entity2971 @entity5 @entity1466 @entity2970 @entity900 @entity189 @entity2879 @entity160 @entity5713 @entity1732 @entity1260 @entity44
Germ-cell @entity5 can be subdivided into germinoma, @entity189 , @entity1466 , @entity2970 (yolk-sac @entity5 ), and @entity44 . They are also distinguished by their production of secreted markers such as @entity160 produced in @entity2970 and @entity189 or beta- @entity1 chorionic gonadotropin, produced by @entity189 . Germinoma and @entity44 produce none of the markers. Because it has been proposed that @entity44 may differentiate from multipotent stem cells contained in @entity189 and are thus lineage related, the presence of markers indicates the presence of a @entity2971 . @entity2971 are an invariably fatal subgroup within the pediatric pineal region germ-cell @entity5 . There is no effective, established therapeutic regimen. We report the treatment regimen for three @entity1 diagnosed with this highly aggressive @entity5 entity. The @entity1 were first given a course of chemotherapy with @entity1732 , @entity2879 , and @entity900 . This resulted in the normalization of markers and the shrinkage of @entity5 . These were then removed by the infratentorial supracerebellar approach. Removal was followed by a second course of chemotherapy with @entity5713 , @entity1260 , and @entity900 ; after which the @entity1 underwent radiotherapy. All three @entity1 are well and without evidence of residual or recurrent disease 20, 30, and 32 months after surgery, respectively. We propose this therapy regimen for @entity1 in whom the markers are positive.
