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Hochmaligne Gliome im Kindes- und Jugendalter

Pediatric high-grade gliomas

  • Leitthema
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Zusammenfassung

Unter den hochmalignen Gliomen des Kindes- und Jugendalters werden unterschiedliche Tumorentitäten glialen Ursprungs zusammengefasst, die durch einen malignen histologischen Phänotyp oder ungünstigen klinischen Verlauf charakterisiert sind. Die häufigsten Tumorentitäten sind das Glioblastom, das anaplastische Astrozytom und das Ponsgliom. Die aktuelle Therapieempfehlung besteht aus Operation, Bestrahlung und Chemotherapie, Ponsgliome werden nur bestrahlt und chemotherapiert. Die komplette Tumorresektion besitzt die größte prognostische Bedeutung. Das Gesamtüberleben ist für die meisten Patienten immer noch schlecht. Eine Ausnahme bilden Säuglinge und Kleinkinder mit hochmalignem Gliom, die unter konventioneller Chemotherapie und Operation ein gutes Überleben zeigen. Für diese Patienten wird aktuell ein eigenes europäisches Chemotherapieprotokoll entwickelt. Für ältere Patienten werden neue multimodale Therapiekonzepte etabliert, in die innovative tumorspezifische Therapeutika integriert werden sollen.

Abstract

Pediatric high-grade gliomas comprise different tumor entities of glial origin that are characterized by their malignant histopathologic phenotype or poor clinical course. Glioblastoma multiforme, anaplastic astrocytoma, and pontine glioma represent the most frequent pediatric high-grade gliomas. Current treatment recommendations include surgery, radiotherapy, and chemotherapy, with the exception of pontine gliomas, which are treated solely by radiotherapy and chemotherapy. Complete tumor resection still has the highest prognostic impact. Although overall survival is still poor for most patients, infants and very young children with high-grade gliomas show good overall survival with conventional chemotherapy and surgery. For these patients, a separate chemotherapy protocol is currently being developed in several European countries. For older patients, new multimodal treatment protocols containing innovative tumor-specific as well as conventional treatment strategies must be established.

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Danksagung

Unser besonderer Dank gilt den Kolleginnen und Kollegen in den Prüfzentren der HIT-GBM- und HIT-HGG-Studien: Aachen, Aarau, Augsburg, Basel, Bayreuth, Berlin, Bielefeld, Bonn, Braunschweig, Bremen, Chemnitz, Cottbus, Dortmund, Dresden, Düsseldorf, Duisburg, Erfurt, Erlangen, Essen, Frankfurt am Main, Freiburg, Gießen, Göttingen, Graz, Greifswald, Hagen, Halle, Hamburg, Hannover, Heidelberg, Heilbronn, Herdecke, Homburg/Saar, Idar-Oberstein, Innsbruck, Jena, Karlsruhe, Kiel, Klagenfurt, Koblenz, Köln, Krefeld, Leipzig, Linz, Ludwighafen, Lübeck, Magdeburg, Mainz, Marburg, Minden, München, Münster, Nürnberg, Oldenburg, Regensburg, Rostock, Salzburg, St. Augustin, St. Gallen, Stuttgart, Trier, Tübingen, Ulm, Wien, Wolfsburg, Würzburg, Wuppertal, Zürich.

Interessenskonflikt

Der korrespondierende Autor weist auf folgende Beziehung/en hin: Der Autor hat Drittmittel zu Forschungszwecken von Fa. Merck und Fa. Celgene erhalten.

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Authors and Affiliations

  1. Universitätsklinik und Poliklinik für Kinder- und Jugendmedizin und HIT-HGG-Studienleitung, Universitätsklinikum Halle, Ernst-Grube-Straße 40, 06120, Halle, Saale, Deutschland

    C. Kramm, U. Rausche , S. Butenhoff & C. Kühnöl

  2. Universitätsklinik und Poliklinik für Diagnostische Radiologie, Universitätsklinikum Halle, Halle, Saale, Deutschland

    C. Kunze

  3. Klinik für Strahlentherapie und Radioonkologie, Universität Leipzig, Leipzig, Deutschland

    R. Kortmann

  4. Department of Pediatrics, MD Anderson Cancer Center, Houston, USA

    J. Wolff

  5. Pediatric Hemato-Oncology and Neuro-Oncology, University Hospital Gasthuisberg, Leuven, Belgien

    S. van Gool

Authors
  1. C. Kramm
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  2. U. Rausche
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  3. S. Butenhoff
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  4. C. Kühnöl
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  5. C. Kunze
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  6. R. Kortmann
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  7. J. Wolff
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  8. S. van Gool
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Corresponding author

Correspondence to C. Kramm.

Additional information

Gefördert von der Deutschen Kinderkrebsstiftung, Bonn.

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Kramm, C., Rausche , U., Butenhoff, S. et al. Hochmaligne Gliome im Kindes- und Jugendalter. Monatsschr Kinderheilkd 156, 1201–1207 (2008). https://doi.org/10.1007/s00112-008-1799-3

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  • DOI: https://doi.org/10.1007/s00112-008-1799-3

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