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Titolo:
Actual and future strategies in interdisciplinary treatment of medulloblastomas, supratentorial PNET and intracranial germ cell tumors in childhood
Autore:
Kortmann, RD; Kuhl, J; Timmermann, B; Calaminus, G; Dieckmann, K; Wurm, R; Sorensen, N; Urban, C; Gobel, U; Bamberg, M;
Indirizzi:
Univ Tubingen, Abt Strahlentherapie, D-72076 Tubingen, Germany Univ Tubingen Tubingen Germany D-72076 erapie, D-72076 Tubingen, Germany Univ Wurzburg, Kinderklin, D-8700 Wurzburg, Germany Univ Wurzburg Wurzburg Germany D-8700 nderklin, D-8700 Wurzburg, Germany Univ Dusseldorf, Kinderklin, D-4000 Dusseldorf, Germany Univ Dusseldorf Dusseldorf Germany D-4000 in, D-4000 Dusseldorf, Germany Allgemeines Krankenhaus Wien, Abt Strahlentherapie, Vienna, Austria Allgemeines Krankenhaus Wien Vienna Austria entherapie, Vienna, Austria Charite, Abt Strahlentherapie, Berlin, Germany Charite Berlin GermanyCharite, Abt Strahlentherapie, Berlin, Germany Univ Wurzburg, Abt Neurochirurg, Wurzburg, Germany Univ Wurzburg Wurzburg Germany urg, Abt Neurochirurg, Wurzburg, Germany Graz Univ, Klin Kinder & Jugendheilkunde, Hamatol Onkol Abt, Graz, AustriaGraz Univ Graz Austria ugendheilkunde, Hamatol Onkol Abt, Graz, Austria
Titolo Testata:
STRAHLENTHERAPIE UND ONKOLOGIE
fascicolo: 9, volume: 177, anno: 2001,
pagine: 447 -
SICI:
0179-7158(200109)177:9<447:AAFSII>2.0.ZU;2-5
Fonte:
ISI
Lingua:
GER
Soggetto:
MALIGNANT BRAIN-TUMORS; PRIMITIVE NEUROECTODERMAL TUMORS; PROSPECTIVE RANDOMIZED TRIAL; PEDIATRIC-ONCOLOGY-GROUP; CRANIOSPINAL RADIATION-THERAPY; CHILDRENS CANCER GROUP; CHIASMATIC-HYPOTHALAMIC GLIOMAS; CENTRAL-NERVOUS-SYSTEM; BONE-MARROW RESCUE; TERM FOLLOW-UP;
Keywords:
childhood; brain tumors; stereotactic radiation therapy; medulloblastoma; germ cell tumors; hyperfractionation;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
96
Recensione:
Indirizzi per estratti:
Indirizzo: Kortmann, RD Univ Tubingen, Abt Strahlentherapie, Hoppe Seyler Str 3, D-72076 Tubingen,Germany Univ Tubingen Hoppe Seyler Str 3 Tubingen Germany D-72076 ny
Citazione:
R.D. Kortmann et al., "Actual and future strategies in interdisciplinary treatment of medulloblastomas, supratentorial PNET and intracranial germ cell tumors in childhood", STRAH ONKOL, 177(9), 2001, pp. 447

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 developmentsin 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 Longterm 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 persistingresidual 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.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 20:45:06