ACNS2321 (CNS Germinoma, Reduced Radiotherapy)

The purpose of this study is to determine if treating germinomas with chemotherapy followed by a lower dose of radiotherapy (RT) can be as effective as the current standard of care. Specifically, our primary aim is to determine whether 12 Gy whole ventricular irradiation (WVI) and 12 Gy tumor boost would maintain similar efficacy compared to ACNS1123 stratum 2 as measured by event-free survival (EFS) in eligible patients with localized primary central nervous system (CNS) germinoma who present with serum and/or CSF human chorionic gonadotropin-beta (hCGß) = 100 IU/L and normal AFP, and meet complete response (CR) or continued complete response (CCR) criteria following chemotherapy/second-look surgery (Stratum 1). We are attempting to build upon the excellent results of ACNS1123 stratum 2 by reducing the RT dose even further for patients in a CR after chemotherapy.