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Gewählte Publikation:

Kortmann, RD; Kühl, J; Timmermann, B; Calaminus, G; Dieckmann, K; Wurm, R; Sörensen, N; Urban, C; Göbel, U; Bamberg, M.
Current and future strategies in interdisciplinary treatment of medulloblastomas, supratentorial PNET (primitive neuroectodermal tumors) and intracranial germ cell tumors in childhood
Strahlenther Onkol. 2001; 177(9): 447-461.
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Autor/innen der Med Uni Graz:
Urban Ernst-Christian
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Abstract:
BACKGROUND: The chances for cure in medulloblastoma, supratentorial primitive neuroectodermal tumors (stPNET) and intracranial germ cell tumors have decisively improved within the last decades. Today long-term survival in the range between 60% and 80% and more than 90%, respectively, can be achieved. The low incidence of brain tumors in childhood and the necessity for optimal patient care has led to the fact that more than 90% of children are treated within national and international controlled studies today in order to assure a constant improvement of therapeutic outcome. Recent developments in neurosurgery achieved complete tumor resections in the majority of children at a low risk for morbidity and mortality. METHODS: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. RESULTS: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting germ cell tumors cisplatin containing chemotherapies in conjunction with radiotherapy achieve a long-term survival rate of 80% today. Especially in high risk medulloblastoma and secreting germ cell tumors chemotherapies are playing an increasingly important role in the interdisciplinary management. It can be expected that future developments of chemotherapeutic protocols and the introduction of new cytostatic substances will further improve the therapeutic outcome. CONCLUSIONS: The therapeutic endeavors of all those caring for children are aiming to study modifications of the therapeutic components in the interdisciplinary approach in order to optimize the therapeutic strategies. In future the affected children and young adolescents should be accrued for the forthcoming cooperative, prospective trial HIT 2000 and ongoing trial SIOP CNS GCT 96, respectively, in order to provide the body of data supporting the selection of novel and optimized approaches for future treatment strategies.
Find related publications in this database (using NLM MeSH Indexing)
Adolescent -
Age Factors -
Antineoplastic Agents - therapeutic use
Brain Neoplasms - drug therapy
Cerebellar Neoplasms - drug therapy
Child - drug therapy
Child, Preschool - drug therapy
Clinical Trials as Topic - drug therapy
Combined Modality Therapy - drug therapy
Disease-Free Survival - drug therapy
Dose Fractionation - drug therapy
Female - drug therapy
Germinoma - drug therapy
Humans - drug therapy
Infant - drug therapy
Infant, Newborn - drug therapy
Male - drug therapy
Medulloblastoma - drug therapy
Multicenter Studies as Topic - drug therapy
Neoplasm Metastasis - drug therapy
Neoplasm Recurrence, Local - drug therapy
Neuroectodermal Tumors, Primitive - drug therapy
Prospective Studies - drug therapy
Radiotherapy Dosage - drug therapy
Risk Factors - drug therapy
Time Factors - drug therapy

Find related publications in this database (Keywords)
childhood
brain tumors
stereotactic radiation therapy
medulloblastoma
germ cell tumors
hyperfractionation
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