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61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

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Randomized multicenter trial on patients with childhood craniopharyngioma (KRANIOPHARYNGEOM 2007) – update after 27 months of recruitment

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  • Ursel Gebhardt - Department of Pediatrics and Pediatric Hematology / Oncology, Klinikum Oldenburg gGmbH, Oldenburg, Germany
  • Rolf-Dieter Kortmann - Department of Radiotherapy and Radiooncology, University Leipzig, Germany
  • Andreas Faldum - Institute for Medical Biometrics, Epidemiology and Informatics, University of Mainz, Germany
  • Monika Warmuth-Metz - Department of Neuroradiology, University Würzburg, Germany
  • Torsten Pietsch - Department of Neuropathology University of Bonn, Germany
  • Christoph Wiegand - Department of Neurosurgery, Evangelisches Krankenhaus, Oldenburg; Germany; on behalf of the study commission KRANIOPHARYNGEOM 2007
  • Niels Sörensen - Department of Neurosurgery, Evangelisches Krankenhaus, Oldenburg; Germany; on behalf of the study commission KRANIOPHARYNGEOM 2007
  • Hermann L. Müller - Department of Pediatrics and Pediatric Hematology / Oncology, Klinikum Oldenburg gGmbH, Oldenburg, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1629

doi: 10.3205/10dgnc102, urn:nbn:de:0183-10dgnc1023

Published: September 16, 2010

© 2010 Gebhardt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Despite high survival rates (92%) in patients with childhood craniopharyngioma (CP), quality of life (QoL) is frequently impaired due to sequelae such as severe obesity resulting from hypothalamic involvement of CP. Based on the results of the multicenter prospective study KRANIOPHARYNGEOM 2000 radical surgery is no appropriate treatment strategy in patients with hypothalamic involvement. Furthermore, tumor progression/relapses are frequent early events in CP patients. The analysis of event-free survival-rates (EFS) in 117 prospectively evaluated patients with CP showed a high rate of early events in terms of tumor progression after incomplete resection (EFS:0.31±0.07) and relapses after complete resection (EFS:0.63±0.09) during the first three years of follow-up.

Methods: Accordingly, in KRANIOPHARYNGEOM 2007 QoL, and survival rates in CP pts (>5yrs at diagnosis) are analyzed after randomization of the time point of irradiation (XRT) after incomplete resection (immediate XRT versus XRT at progression of residual tumor).

Results: Up to now (12/09) 52 pts with CP were recruited (29 pts in the randomization arm; 19 pts in the surveillance arm; 4 pts in the process of review of imaging). 11 of 29 pts were randomized. 7 pts could not be randomized due to parental decision, late schedule (6 pts) and due to decision of the physician (5 pts).

Conclusions: In conclusion, KRANIOPHARYNGEOM 2007 represents the first randomized trial in CP and the first study in pediatric neurooncology analyzing QoL as an endpoint. Aim of the study is to analyze the appropriate time point of XRT in order to improve QoL in patients with hypothalamic involvement.

Supported by Deutsche Kinderkrebsstiftung (www.kinderkrebsstiftung.de).