BACKGROUND: The aim of this study is to assess quality of life (QOL) of extremely long-time survivors with germinoma mainly treated with radiotherapy. METHODS: Fifty-two of sixty-eight patients receiving radiotherapy from 1968 to 1995 in our hospital were enrolled. They were 41 males/11 females, and their age at initial diagnosis ranged from 7 to 32 years (median 14.2 years). Tumor developed at the area involving neurohypophysis in 23, and non- neurohypophysis in 29. They underwent radiotherapy with the median doses of 48.2 Gy (range, 40.0 to 60.2 Gy). Median follow-up periods were 240 months (range, 0-468 months). Clinical outcome and QOL were evaluated retrospectively. RESULTS: Six patients had recurrent tumors. Six had second tumors (glioma) within irradiated field. Main causes of 13 deaths were not tumor progression, but other complications, especially second tumor. Actuarial survival rates are 83.6% in 10 years, 77.5% in 20, and 33.3% in 30, respectively. Of forty-four patients, six married and three males with solitary pineal tumor had a child. Highest academic career in thirty-two patients was characterized by graduate of senior high school or less in 14, more in 18. Twenty-one have had no occupation, and seven of eleven had left their jobs after employment. CONCLUSIONS: Radiotherapy from 1968 to 1995 provided the patients with germinoma with satisfactory outcome and unsatisfactory declined QOL. SECONDARY CATEGORY: Clinical Neuro-Oncology.