Abstract
Intracranial germ cell tumors (GCTs) primarily affect children and young adults, with favorable outcomes through r adiotherapy and chemotherapy. However, radiation-induced secondary malignancies pose significant concerns in long-term survivors, particularly regarding optimal treatment strategies. We present a case of a 12-year-old Asian male initially diagnosed with pineal region GCTs who developed radiation-induced glioblastoma after 5 years of tumor-free survival. The secondary tumor was successfully treated with chemoradiotherapy combined with Tumor Treating Fields (TTFields), resulting in tumor regression and survival exceeding 3 years. This case demonstrates the potential efficacy of TTFields combined with chemoradiotherapy in treating radiation-induced glioblastoma in young patients and highlights the importance of long-term surveil-lance in pediatric tumor patients.