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Protonentherapie – Eine Chance in der Therapie von Kopf-Hals- und Schädelbasistumoren

Proton therapy—a chance in the treatment of tumors of the head and neck and base of skull

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Zusammenfassung

Hintergrund

Die Radiotherapie (RT) ist integraler Bestandteil der Behandlung vieler Tumoren in der Nachbarschaft empfindlicher Organe und Strukturen, zu denen insbesondere auch Kopf-Hals- und Schädelbasistumoren zählen. Aufgrund der mit einer Strahlentherapie verbundenen Risiken von Nebenwirkungen wird die Nutzung hochkonformaler RT-Techniken favorisiert. Für viele Indikationen ist daher die Protonentherapie (PT) bereits Teil des modernen Behandlungsstandards.

Ziel der Arbeit

Übersicht über heutige Indikationen für PT mit Schwerpunkt auf Tumoren im Kopf-Hals-Bereich und der Schädelbasis. Zusammenfassung und Diskussion relevanter Ergebnisse und aktueller Entwicklungen.

Material und Methoden

Bewertung relevanter Studien und Zusammenschau aktueller Fragestellungen der PT für Tumoren im Kopf-Hals- und Schädelbasisbereich.

Ergebnisse

Die Untersuchungen zur PT weisen insgesamt vielversprechende Ergebnisse auf. Neben den dosimetrischen Untersuchungen deuten auch klinische Studien auf Vorteile der PT hin, besonders hinsichtlich der Reduzierung von Nebenwirkungen.

Diskussion

Gegenwärtig wird besonders die Nutzung des „model-based approach“ diskutiert. Hierdurch sollen anhand der „normal tissue complication probability“ (NTCP) die Patienten identifiziert werden, die besonders von einer PT profitieren. Weiterhin wird die PT für die Re-RT diskutiert.

Abstract

Background

Radiotherapy (RT) is an integral part of the treatment of many tumors located in the vicinity of sensitive organs and structures, including tumors of the head and neck and base of skull in particular. Due to the risk of side effects associated with RT, the use of highly conformal RT techniques is favored. For many indications, proton therapy (PT) is therefore already part of the modern treatment standard.

Objective

This article presents an overview of current indications for PT with emphasis on tumors in the head and neck region and the base of skull. Furthermore, a summary and discussion of relevant results and current developments are included.

Materials and methods

The work comprises an evaluation of relevant studies and an overview of current issues related to PT of tumors in the areas of the head, neck, and base of skull.

Results

Overall, the studies on PT show promising results. In addition to dosimetric studies, clinical studies also point to advantages of PT, especially with regard to the reduction of side effects.

Discussion

Currently, use of the model-based approach is being discussed. This is intended to identify those patients who benefit most from PT based on the normal tissue complication probability (NTCP). PT for re-RT is also discussed.

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Danksagung

Die Autorin dankt Frau R. Frakulli, Frau C. Behrends und Frau T. Steinmeier für die Hilfe beim Erstellen des Manuskriptes und des Bildmaterials.

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  1. Klinik für Partikeltherapie, Westdeutsches Protonentherapiezentrum Essen, Universitätsklinikum Essen, Hufelandstr. 55, 45147, Essen, Deutschland

    Beate Timmermann

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Correspondence to Beate Timmermann.

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B. Timmermann gibt an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Timmermann, B. Protonentherapie – Eine Chance in der Therapie von Kopf-Hals- und Schädelbasistumoren . HNO 68, 640–647 (2020). https://doi.org/10.1007/s00106-020-00915-z

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  • DOI: https://doi.org/10.1007/s00106-020-00915-z

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