2019 Volume 56 Issue 5 Pages 464-468
Reduced-intensity chemotherapy is often considered for Down syndrome (DS) patients with malignancies. Tolerance to conventional chemotherapy in DS patients with intracranial germ cell tumors (GCTs) is unclear. A 13-year-old boy with DS presented with headache and disturbed eye movement. He underwent cranial magnetic resonance imaging, which revealed a pineal tumor. The tumor was resected completely. Histopathological examination of the tumor led to the diagnosis of mixed GCT composed of immature teratoma with pineal choriocarcinoma. The patient received six courses of ifosfamide, carboplatin, and etoposide (ICE) regimen in combination with proton therapy. Considering toxicities, the first ICE course was decreased to 60% of the predetermined doses, and there were no severe adverse events. Therefore, the five remaining ICE courses were administered at full doses, without severe adverse events. This case indicated that conventional doses of the ICE regimen might be feasible and effective for intracranial GCTs in children with DS.
