Lehrstuhl für Kinderheilkunde
Josef-Schneider-Str. 2, 97080 Würzburg
Other participating persons and organisations:
Research foci (and basic equipment-based research projects):
The prospective multicenter trial HIT 2000 for treatment of children and young adults with an intracranial primitive neuroectodermal tumor (PNET/Medulloblastoma) and Ependymoma is conducted at the children?s hospital of the University of Wuerzburg. Primary aims are to increase the probabilitity of PFS and EFS of study patients by intensified chemotherapy and/or radiotherapy, by risk-adapted therapy for exactly defined risk-groups and by improvement of quality control. Further aims are to reduce late sequelae by reduction or substitution of radiotherapy in younger children with medulloblastoma. A randomized phase-III trial is designed to investigate if patients from 4-21 years of age without metastasis can reach an increased PFS by a hyperfractionated radiotherapy regimen compared to a conventional radiotherapy regimen with a reduced craniospinal dosis. A national reference center for CSF-analysis in children with malignant brain tumors has been established. Neuropsychological studies are conducted to determine residual deficiencies and quality of life of children with medulloblastoma. Polymorphisms in host defense molecules are studied in immunocompromised patients in order to find out if certain genotypes predispose to more severe infectious diseases and complications.
Results of the ongoing trial HIT 2000 are not available yet, as the study will be open until 31.12.2005. Concerning the results of the previous trial HIT?91, children without metastasis achieved a 4 yr-PFS of 79% by radiotherapy and mainainance-chemotherapy. PFS of patients with metastasis was significantly worse, reaching 34%. PFS of patients with supratentorial PNET without metastasis was 49%, and in patients with ependymoma and age 4-21 years 49%. In general, toxicity was as expected and tolerable. Results of the previous infant trial HIT-SKK?92: children <4 years of age with medulloblastoma without metastasis had a 6 year PFS of 74 % bysubstition of radiotherapy with intraventricularly applicated methotrexate. This result was not reached by other international trials, even by more aggressive therapeutic regimens.