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Hirntumoren bei Kindern und Jugendlichen

Standards und neue Entwicklungen in Diagnostik und Therapie

Childhood brain tumors

Standards and recent developments in diagnostics and treatment

  • Leitthema
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Der Onkologe Aims and scope

Zusammenfassung

In Deutschland erkranken jährlich etwa 380 Kinder und Jugendliche unter 16 Jahren an einem Hirntumor. Das Spektrum der Hirntumoren unterscheidet sich dabei erheblich von dem erwachsener Patienten. Die Diagnosestellung erfolgt trotz charakteristischer Symptome oft verzögert. Daher sind auch unspezifische Symptome bei Persistenz weiter abzuklären. Seit den 80er Jahren werden im Auftrag der Gesellschaft für Pädiatrische Onkologie und Hämatologie (GPOH) multimodale Behandlungskonzepte in Therapie(-optimierungs)studien systematisch weiterentwickelt. Je nach Histologie, Metastasierungsgrad und Alter kommen dabei Operation, Chemotherapie und Bestrahlung in zunehmend differenzierter Form zum Einsatz. Derzeit werden 80–90% der in Deutschland an Hirntumoren erkrankten Kinder im Rahmen des „Behandlungsnetzwerks HIT“ behandelt. Hauptziele sind die Verbesserung von Überlebensraten und Lebensqualität, die Verminderung von therapieassoziierter Toxizität und Spätfolgen sowie die Verbesserung diagnostischer und therapeutischer Standards. Im Folgenden werden typische Leitsymptome, diagnostische Empfehlungen und Therapiestrategien vorgestellt.

Abstract

Every year, around 380 children younger than 16 years are diagnosed in Germany with a brain tumor. Different types of brain tumors are found in children compared to adults. Diagnosis is often delayed in spite of presentation with characteristic symptoms. Thus, unspecific, persistent symptoms should be followed up with further diagnostics. Since the 1980s, multimodal therapeutic regimens have been developed systematically by the Society for Pediatric Oncology and Hematology in the context of treatment optimization trials. Neurosurgery, chemotherapy and radiation are applied according to the histology, stage of metastasis, and age of the children. Currently, 80–90% of children diagnosed with a brain tumor in Germany are treated within the framework of the ‘treatment network HIT’. The principle aims are improved survival and quality of life, the reduction of therapy-associated toxicity and late effects, and better diagnostic and therapeutic standards. In this article, typical clinical symptoms, diagnostic recommendations and treatment strategies are described.

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Authors and Affiliations

  1. Kinderklinik und Poliklinik des Universitätsklinikums Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg

    S. Rutkowski

  2. Klinik für Kinder und Jugendliche, Klinikum Augsburg

    A. Gnekow

  3. Universitätskinderklinik Bonn

    G. Fleischhack

  4. Klinik St. Hedwig, Krankenhaus Barmherzige Brüder, Universität Regensburg

    S. Wagner

  5. Universitätsklinikum Düsseldorf, Klinik für Kinder-Onkologie, -Hämatologie und -Immunologie, Düsseldorf

    G. Calaminus

  6. Dept. Pediatrics, Section Ped. Neurooncology, MD Anderson Cancer Center, University of Texas

    J. Wolff

  7. Kinderklinik des Klinikums Oldenburg

    H. Müller

  8. Abt. für Pädiatrische Neurochirurgie, Universität Würzburg

    N. Sörensen

  9. Institut für Medizinische Biometrie, Epidemiologie und Informatik, Universität Mainz

    A. Faldum

  10. Klinik für Neurochirurgie, Universität Tübingen

    M. Tatagiba

  11. Institut für Neuropathologie, Universität Bonn

    T. Pietsch

  12. Abt. für Neuroradiologie, Universität Würzburg

    M. Warmuth-Metz

  13. Klinik für Strahlentherapie und Radioonkologie, Universität Leipzig

    R. Kortmann

Authors
  1. S. Rutkowski
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  2. A. Gnekow
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  3. G. Fleischhack
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  4. S. Wagner
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  5. G. Calaminus
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  6. J. Wolff
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  7. H. Müller
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  8. N. Sörensen
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  9. A. Faldum
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  10. M. Tatagiba
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  11. T. Pietsch
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  12. M. Warmuth-Metz
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  13. R. Kortmann
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Corresponding author

Correspondence to S. Rutkowski.

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Rutkowski, S., Gnekow, A., Fleischhack, G. et al. Hirntumoren bei Kindern und Jugendlichen. Onkologe 12, 533–545 (2006). https://doi.org/10.1007/s00761-006-1048-0

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  • DOI: https://doi.org/10.1007/s00761-006-1048-0

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