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Background  The aim of this study was to investigate the clinical characteristics and outcomes of patients with primary malignant mediastinal non‐seminomatous germ cell tumor ( MMNSGCT ) by comparing the efficacies of different treatment modalities.    Methods  The charts of 62 consecutive patients with  MMNSGCT  between 1990 and 2010 were reviewed. Analyses included  K aplan‐ M eier survival and Cox multivariate regression.    Results  There was sufficient data of 61 patients for inclusion in the study. The median age was 25 years. At diagnosis, 35 patients had tumors located in the mediastinum, 26 had lung and/or distant metastases. At a median follow‐up of 47.2 months, 32 patients had died and 43 had developed progressive disease. The one, three, and five‐year overall survival ( OS ) and progression‐free survival ( PFS ) rates were 72.1%, 50.8%, 49.2% and 47.5%, 32.8%, 32.8%, respectively. Patients who received radiotherapy in the primary treatment regimen showed improved five‐year  OS  (68.2% vs. 38.5%,  P  =  0.043 ),  PFS  (45.5% vs. 20.5%,  P  =  0.023 ), and local recurrence‐free survival ( LRFS ) (77.3% vs. 38.5%,  P  =  0.003 ) compared with those who did not receive radiotherapy. Multivariate analysis revealed that radiotherapy was an independent prognostic factor of five‐year  OS  (hazard ratio [ HR]  0.39,  P  =  0.037 ),  PFS  ( HR  0.42,  P  =  0.017 ), and  LRFS  ( HR  0.31,  P  =  0.019 ).    Conclusion  Radiotherapy in a chemotherapy‐based treatment regimen could significantly reduce local recurrence and improve survival of  MMNGCT  patients.

thoracic cancer

Role of radiotherapy in treating patients with primary malignant mediastinal non‐seminomatous germ cell tumor: A 21‐year experience at a single institution