Evidence map›Paper›PMID 41996009›Full record

ArticleJournal of neuro-oncology2026

Marrow-ablative chemotherapy and re-irradiation are associated with improved overall survival in patients with relapsed central nervous system nongerminomatous germ cell tumors.

Mohammad H Abu-Arja, Zeynab Rajabi, Mary Claire McGlynn, Rahawa T Ghebrelul, Mark Zobeck, Sarah Harasis, Jyoti Arora, Mohammed Saad Zaghloul, Ahmed Elhemaly, Kelsey Bertrand and 13 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Mohammad H Abu-Arja *Texas Children's Cancer and Hematology Center, Texas Children's Hospital, 1102 Bates Ave, Houston, TX, 77030, USA. Mohammad.AbuArja@bcm.edu.ORCID http://orcid.org/0000-0003-4606-2269
Zeynab Rajabi *Texas Children's Cancer and Hematology Center, Texas Children's Hospital, 1102 Bates Ave, Houston, TX, 77030, USA.
Mary Claire McGlynnThe Division of Hematology, Oncology, and Blood and Marrow Transplantation, St. Louis Children's Hospital, Washington University School of Medicine, 660 South Euclid Avenue Campus Box 8116, St. Louis, MO, USA.
Rahawa T GhebrelulTexas Children's Cancer and Hematology Center, Texas Children's Hospital, 1102 Bates Ave, Houston, TX, 77030, USA.
Mark ZobeckTexas Children's Cancer and Hematology Center, Texas Children's Hospital, 1102 Bates Ave, Houston, TX, 77030, USA.
Sarah HarasisThe University of Jordan Faculty of Medicine, Amman, Jordan.
Jyoti AroraCenter for Biostatistics and Data Science, Institute for Informatics, Data Science and Biostatistics, Washington University School of Medicine, St. Louis, MO, USA.
Mohammed Saad ZaghloulDepartment of Radiation Oncology, National Cancer Institute, Cairo University, & Children Cancer Hospital of Egypt, Cairo, Egypt.
Ahmed ElhemalyDivision of Pediatric Oncology, National Cancer Institute, Cairo University, and Children's Cancer Hospital of Egypt, Cairo, Egypt.
Kelsey BertrandSt Jude Children's Research Hospital, Memphis, TN, USA.
Amar GajjarSt Jude Children's Research Hospital, Memphis, TN, USA.
Rebecca RonsleyThe Department of Pediatrics, Seattle Children's Hospital, and the University of Washington, Seattle, WA, USA.
Andrea M CappellanoPediatric Oncology, IOP-GRAACC/Federal University of São Paulo, São Paulo, Brazil.
Natalia DassiPediatric Oncology, IOP-GRAACC/Federal University of São Paulo, São Paulo, Brazil.
Malgorzata CzogalaThe Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.
Richard T GrahamThe Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Truman KnowlesDepartment of Neurology, University of California, San Francisco, CA, USA.
Sabine MuellerDepartment of Neurology, University of California, San Francisco, CA, USA.
Michael J FisherDivision of Oncology, The Children's Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Jonathan L FinlayDepartments of Pediatrics and Radiation Oncology, The Ohio State University, College of Medicine, Columbus, OH, USA.
Girish DhallThe Department of Pediatrics, Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
Sumanth Nagabushan *The Kids Cancer Centre, Sydney Children's Hospital and University of New South Wales, Randwick, New South Wales, Australia.
Mohamed S Abdelbaki *The Division of Hematology, Oncology, and Blood and Marrow Transplantation, St. Louis Children's Hospital, Washington University School of Medicine, 660 South Euclid Avenue Campus Box 8116, St. Louis, MO, USA. mohameda@wustl.edu.ORCID http://orcid.org/0000-0002-8262-7469

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRelapsed/refractory central nervous system nongerminomatous germ cell tumors (NGGCTs) have a poor prognosis. We explored prognostic factors that may guide the management of relapsed/refractory NGGCTs.

methodsWe performed a multinational retrospective study of relapsed/refractory NGGCTs. Data were summarized using standard descriptive statistics. Overall survival (OS) was estimated using the Kaplan-Meier method. Prognostic factors were evaluated with univariable and multivariable Cox proportional hazards models, reported as hazard ratios (HR) with 95% confidence intervals (CI).

resultsWe identified 30 patients from seven centers in four countries. The median age at initial diagnosis was 12 years (IQR: 10,15). Twenty patients experienced relapse, and 10 had treatment-refractory disease. The median follow-up time since relapse/progression was eight months (IQR: 2,29). The median time to relapse was 12 months (IQR: 7,22). Eleven (37%) received myeloablative chemotherapy (HDCx) with autologous hematopoietic stem cell rescue (AuHCR), and 16 (57%) received re-irradiation. Ten patients survived at the last follow-up, all of whom had achieved a complete response at the end of therapy. Among the 10 survivors, three received HDCx, one received re-irradiation, and six received both. HDCx (HR = 0.08, 95%CI: 0.018–0.36; p = 0.001) and re-irradiation at relapse (HR = 0.403, 95%CI: 0.16–1.004; p = 0.051) suggest survival benefit. In multivariable analysis, HDCx was independently associated with improved OS regardless of re-irradiation and relapse/progression status (HR = 0.111, 95%CI: 0.023–0.532; p = 0.006). The 3-year OS of patients who received HDCx or re-irradiation was 76% (95%CI: 51–100%) and 33% (95%CI: 14%-77%) compared with patients who did not receive HDCx 5.3% (95%CI: 0.8%-35%), or re-irradiation 17% (95%CI: 4.7%-59%), respectively (p < 0.05).

conclusionHDCx and/or re-irradiation are associated with improved OS. The retrospective design, small sample size, histologic heterogeneity, and survival bias limit interpretation. To guide future therapies, collaborative studies are needed to elucidate biological differences between long-term survivors and non-survivors.

Indexed as

Central Nervous System NeoplasmsNeoplasm Recurrence, LocalNeoplasms, Germ Cell and EmbryonalRe-IrradiationTesticular NeoplasmsAdolescentAdultChildCombined Modality TherapyFollow-Up StudiesHumansMalePrognosisRetrospective StudiesSurvival RateYoung AdultChemotherapyGerm cell tumorHigh-dose chemotherapyNongerminomatous germ cell tumorsRadiotherapy

Identifiers

PMID41996009

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.