A Study of Lower Radiotherapy Dose to Treat Children With CNS Germinoma

Will be estimated for eligible and evaluable patients assigned to Stratum 3 using KM methods at 2 and 3 years with respective 80% two-sided confidence intervals. Time from initiation of radiation to the first occurrence of any of the following events: biochemical or radiographic disease progression, disease recurrence, second malignant neoplasm, or death from any cause.

Will report the response rates using the respective sample proportions and exact binomial two-sided 95% confidence intervals.

Will report the response rates using the respective sample proportions and exact binomial two-sided 95% confidence intervals.

Will use KM methods to estimate stratum-specific OS.

Will be estimated separately for eligible and evaluable patients assigned to Stratum 4 and 5 using KM methods at 2 and 3 years with respective 80% two-sided confidence intervals. Time from initiation of radiation to the first occurrence of any of the following events: biochemical or radiographic disease progression, disease recurrence, second malignant neoplasm, or death from any cause.

Will be estimated separately for eligible and evaluable patients assigned to Stratum 6 and 7 using KM methods at 2 and 3 years with respective 80% two-sided confidence intervals. Time from initiation of radiation to the first occurrence of any of the following events: biochemical or radiographic disease progression, disease recurrence, second malignant neoplasm, or death from any cause.

Will be reported as the number of cerebral vascular events.

Will be assessed by Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) or Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) Digit Span subtest depending on age. Mean scores over time will be computed for each stratum.

Will be assessed by California Verbal Learning Test - Children's Version for 5 years through 17 years or California Verbal Learning Test - Third for ages 17 and up depending on age. Mean scores over time will be computed for each stratum.

Will be assessed by the Behavioral Rating Inventory of Executive Function (BRIEF-2 and BRIEF-A) depending on patient's age. Mean scores over time will be computed for each stratum.

Will be assessed by the PedsQL 4.0 Generic Module. Mean scores over time will be computed for each stratum.

Will be estimated for eligible and evaluable patients assigned to Stratum 2 using KM methods at 2 and 3 years with respective 80% two-sided confidence intervals. Time from initiation of radiation to the first occurrence of any of the following events: biochemical or radiographic disease progression, disease recurrence, second malignant neoplasm, or death from any cause.

Will be summarized by the Kalbfleisch-Prentice cumulative incidence function approach, separately by stratum and by neuroendocrine dysfunction event. Competing risks will include disease progression and death, and patients without events or competing risks will be censored at the time of their last follow-up.

Will be assessed by processing speed index tasks for the Wechsler Preschool and Primary Scale of Intelligence - Fourth Edition, Wechsler Intelligence Scale for Children - Fifth Edition (WISC-V) or Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) depending on age. The mean processing speed at 30-months post-diagnosis in ACNS2321 Stratum 1 patients will be compared to the respective mean in ACNS1123 Stratum 2 patients who had a complete response/continued complete response and received 18 grey (Gy) whole ventricle irradiation + 12 Gy boost to primary site.