The nodes will be dimensioned according to the size of the text, here an option that allows you to change the size of each node, but in turn reduces the size of the text, if you want to keep the size of the text, there is also the option that keeps the text and It allows you to draw a circle according to the size you want, which can indicate some type of value.
For the case of document size you can use the standalone class, which allows you to draw whatever you get in the output according to what you draw. Then you can import the pdf document generated using the graphics library, and include the drawing as any image, without losing the vector properties of the drawing made in tikz.
USING:
\draw[knoten] (-5.0269,-1.2254) circle (0.5cm) node (100440122122){Bous};
\draw[knoten] (-8.7754,5.1376) circle (1cm) node (100420113113){Merzig,\\Kreisstadt};
\draw[knoten] (-8.0377,2.0813) circle (1cm) node (100440114114){Rehlingen-Siersburg};
\draw[knoten] (6.1592,1.6599) circle (1cm) node (100450111111){Bexbach,\\Stadt};
\draw[knoten] (2.2251,0.811) circle (1cm) node (100410511511){Friedrichsthal,\\Stadt};
\draw[knoten] (-1.8769,-5.3392)circle (1cm) node (100410516516){Quierschied};
\draw[knoten] (4.4419,1.4106) circle (1.2cm) node (100430114114){Neunkirchen\\Kreis\\stadt};
\draw[knoten] (-7.0226,0.624) circle (1cm) node (100440121121){Wallerfangen};
\draw[knoten] (-4.446,-0.1781) circle (1.5cm) node (100440118118){Schwalbach};
\draw[knoten] (1.3201,5.106) circle (1cm) node (100460112112){Marpingen};
\draw[knoten] (1.3887,-0.3528) circle (1cm) node (100410518518){Sulzbach/Saar,\\Stadt};
\draw[knoten] (4.9395,-6.1119) circle (2cm) node (100450113113){Gersheim};
RESULT:

USING: A drawing command definition \Knoten that uses scope and transform shape...
\Knoten(-5.0269,-1.2254)[0.8]{Bous};
\Knoten(-8.7754,5.1376)[1]{Merzig, \\Kreisstadt};
\Knoten(-8.0377,2.0813)[0.8]{Rehlingen\\Siersburg};
\Knoten(6.1592,1.6599)[0.8]{Bexbach, \\Stadt};
\Knoten(2.2251,0.811)[0.5]{Friedrichsthal,\\ Stadt};
\Knoten(-1.8769,-5.3392)[1]{Quierschied};
\Knoten(4.4419,1.4106)[0.8]{Neunkirchen,\\ Kreisstadt};
\Knoten(-7.0226,0.624)[0.9]{Wallerfangen};
\Knoten(-4.446,-0.1781)[0.8]{Schwalbach};
\Knoten(1.3201,5.106)[1]{Marpingen};
\Knoten(1.3887,-0.3528)[0.6]{Sulzbach/Saar,\\ Stadt};
\Knoten(4.9395,-6.1119)[1]{Gersheim};
RESULT:

MWE:
\documentclass[border=5mm]{standalone}
\usepackage{tikz}
\usepackage{graphicx}
\begin{document}
\begin{tikzpicture}[
%Environment styles
knoten/.style={%Style for normal shapes
fill=green,
fill opacity=.2,
draw opacity=0.2,
text opacity=1,
align=center
}
]
%New Tikz Objet
\def\Knoten(#1)[#2]#3{%#1: Position#2: Identifier.
\begin{scope}[shift={(#1)},scale=#2, every node/.append style={transform shape}] % using to make coordinate objet.
\node[
draw,
circle,
fill=blue,
fill opacity=.2,
draw opacity=1,
text opacity=1,
align=center
] at (0,0){#3}; %set this coordinate as anode
\end{scope}
}
% Background map obtained from google maps.
\node[inner sep=0pt] (FIG1) at (0,0) {\includegraphics[scale=1]{MAP}};
% Scaling the shapes.
\Knoten(-5.0269,-1.2254)[0.8]{Bous};
\Knoten(-8.7754,5.1376)[1]{Merzig, \\Kreisstadt};
\Knoten(-8.0377,2.0813)[0.8]{Rehlingen\\Siersburg};
\Knoten(6.1592,1.6599)[0.8]{Bexbach, \\Stadt};
\Knoten(2.2251,0.811)[0.5]{Friedrichsthal,\\ Stadt};
\Knoten(-1.8769,-5.3392)[1]{Quierschied};
\Knoten(4.4419,1.4106)[0.8]{Neunkirchen,\\ Kreisstadt};
\Knoten(-7.0226,0.624)[0.9]{Wallerfangen};
\Knoten(-4.446,-0.1781)[0.8]{Schwalbach};
\Knoten(1.3201,5.106)[1]{Marpingen};
\Knoten(1.3887,-0.3528)[0.6]{Sulzbach/Saar,\\ Stadt};
\Knoten(4.9395,-6.1119)[1]{Gersheim};
%IF you use TikzEdt, you can find the coordinates draggin an overlay.
% \draw[knoten] (-5.0269,-1.2254) circle (0.5cm) node (100440122122){Bous};
% \draw[knoten] (-8.7754,5.1376) circle (1cm) node (100420113113){Merzig,\\Kreisstadt};
% \draw[knoten] (-8.0377,2.0813) circle (1cm) node (100440114114){Rehlingen-Siersburg};
% \draw[knoten] (6.1592,1.6599) circle (1cm) node (100450111111){Bexbach,\\Stadt};
% \draw[knoten] (2.2251,0.811) circle (1cm) node (100410511511){Friedrichsthal,\\Stadt};
% \draw[knoten] (-1.8769,-5.3392)circle (1cm) node (100410516516){Quierschied};
% \draw[knoten] (4.4419,1.4106) circle (1.2cm) node (100430114114){Neunkirchen\\Kreis\\stadt};
% \draw[knoten] (-7.0226,0.624) circle (1cm) node (100440121121){Wallerfangen};
% \draw[knoten] (-4.446,-0.1781) circle (1.5cm) node (100440118118){Schwalbach};
% \draw[knoten] (1.3201,5.106) circle (1cm) node (100460112112){Marpingen};
% \draw[knoten] (1.3887,-0.3528) circle (1cm) node (100410518518){Sulzbach/Saar,\\Stadt};
% \draw[knoten] (4.9395,-6.1119) circle (2cm) node (100450113113){Gersheim};
\end{tikzpicture}
\end{document}
If you save the code in a tex archive named as examplehelp33.tex; when you compile you can obtain examplehelp33.pdf and then you can include it in your main document, try with the code below:
% arara: pdflatex: {synctex: yes, action: nonstopmode}
\documentclass[a4paper]{article}
\usepackage[top=2cm,bottom=2cm,left=3cm,right=2cm]{geometry}
\usepackage{graphicx}
\usepackage{lipsum}
\usepackage{tikz}
\usetikzlibrary{backgrounds}
\begin{document}
\lipsum[1-2]
\begin{figure}[!h]
\centering
\includegraphics[width=\textwidth]{examplehelp33}
\caption{Imported pdf using graphicx}
\end{figure}
\lipsum[3-4]
\begin{figure}[!h]
\centering
\begin{tikzpicture}
\node[inner sep=0pt] (FIG1) at (0,0) {\includegraphics[scale=0.8,angle=90]{examplehelp33}};
\end{tikzpicture}
\caption{Imported pdf within Tikz environment}
\end{figure}
\end{document}
RESULT:
NOTE: some border is added in the pdf output from the tikz code by \documentclass[border=5mm]{standalone}. cou can erase this opcode or defining as 0mm.
