OBJECTIVE: To evaluate the long-term effect of chemotherapy combined with radiotherapy in treatment of intracranial germinomas. METHODS: Chemotherapy combined with radiotherapy was given to 45 patients with intracranial germinomas, 24 in the pineal region, 8 in the pineal and suprasellar regions, 4 in the suprasellar region, and 3 in the pineal region and cerebral ventricle from December 1993 to December 1996. Vincristine (VCR), methotrexate (MTX), bleomycin and cisplatin were administered for 4 days as a course of treatment. Then blood routine examination was taken twice a week and blood biochemical examination was taken once a week. A repeat course of chemotherapy was started 4 weeks after if no abnormality in blood examination was found. Local radiotherapy was taken with low to middle dosage (25 - 35 Gy) 1 - 2 months after the second course of chemotherapy. CT and/or MRI examination are made regularly. 39 patients had been followed up for 5 - 8 years. RESULTS: Out of the 39 cases followed-up, one with the relapsing tumor had undergone operation and radiotherapy 2 years before and was given chemotherapy alone without radiotherapy re-relapsed and died in 4 years. One case relapsed 5 years after chemotherapy and radiotherapy and then was given chemotherapy for two more courses with the result of a shrinking of tumor by 80%. During the follow-up 37 patients (95%) survived without relapse of tumor and resumed their normal work or schooling. CONCLUSION: Chemotherapy combined with local radiotherapy with low to middle dosage is the best choice for treatment of intracranial germinomas.