Journal of Neuro-Oncology

, Volume 81, Issue 2, pp 217–223

Childhood pineoblastoma: experiences from the prospective multicenter trials HIT-SKK87, HIT-SKK92 and HIT91

  • Bernward G. Hinkes
  • Katja von Hoff
  • Frank Deinlein
  • Monika Warmuth-Metz
  • Niels Soerensen
  • Beate Timmermann
  • Uwe Mittler
  • Christian Urban
  • Udo Bode
  • Torsten Pietsch
  • Paul G. Schlegel
  • Rolf D. Kortmann
  • Joachim Kuehl
  • Stefan Rutkowski
Clinical Study - patient studies

Abstract

Objective

To analyze the outcome of children with pineoblastoma (PB), treated within the prospective multicenter trials HIT-SKK87, HIT-SKK92 and HIT91 of German-speaking countries.

Patients

We report on 11 children suffering from PB. Five children younger than 3 years of age received chemotherapy after surgery until eligible for radiotherapy (HIT-SKK87 and HIT-SKK92). Five of six children older than 3 years were treated after surgery with immediate chemotherapy and craniospinal irradiation, and one child received maintenance chemotherapy after postoperative radiotherapy (HIT91).

Results

Five of the six older children are still alive in continuous complete remission (CCR) with a median overall survival (OS) and progression free survival (PFS) of 7.9 years. Five of these six HIT91 patients responded to postoperative chemotherapy and radiotherapy. The only patient with tumor progression during initial chemotherapy achieved complete remission with radiotherapy and is alive. In contrast, all five young children died of tumor progression after a median OS of 0.9 years (PFS 0.6 years). They had either metastatic disease (M1) and/or postoperative residual tumor. Response to postoperative chemotherapy was lower than in the older age group, and only one of these children received radiotherapy.

Conclusions

Combined chemotherapy and radiotherapy were feasible and effective in the older age group, leading to prolonged remissions in five of six children. Tumor biology may be more aggressive in younger children with PB, who presented more frequently with high-risk features at diagnosis and had poorer response rates to neoadjuvant postoperative chemotherapy. More intensified treatment regimens may be needed for young children with PB.

Keywords

Pineoblastoma PNET Supratentorial PNET Young children Chemotherapy Radiotherapy Trial 

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Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  • Bernward G. Hinkes
    • 1
  • Katja von Hoff
    • 1
  • Frank Deinlein
    • 1
  • Monika Warmuth-Metz
    • 2
  • Niels Soerensen
    • 3
  • Beate Timmermann
    • 4
  • Uwe Mittler
    • 5
  • Christian Urban
    • 6
  • Udo Bode
    • 7
  • Torsten Pietsch
    • 8
  • Paul G. Schlegel
    • 1
  • Rolf D. Kortmann
    • 9
  • Joachim Kuehl
    • 1
  • Stefan Rutkowski
    • 1
  1. 1.Children’s University HospitalUniversity of WuerzburgWuerzburgGermany
  2. 2.Department of NeuroradiologyUniversity of WuerzburgWuerzburgGermany
  3. 3.Department of Pediatric NeurosurgeryUniversity of WuerzburgWuerzburgGermany
  4. 4.Division of Radiation MedicinePaul Scherrer InstituteVilligenSwitzerland
  5. 5.Department of PediatricsUniversity of MagdeburgMagdeburgGermany
  6. 6.Department of PediatricsUniversity of GrazGrazAustria
  7. 7.Department of Pediatric OncologyUniversity of BonnBonnGermany
  8. 8.Department of NeuropathologyUniversity of BonnBonnGermany
  9. 9.Department of Radiation OncologyUniversity of LeipzigLeipzigGermany

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