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Multimodale Therapiekonzepte beim metastasierten Mammakarzinom

Multimodality treatment concepts for metastatic breast cancer

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Zusammenfassung

Während das metastasierte Mammakarzinom bei den meisten Patientinnen als Systemerkrankung verstanden wird, so gibt es doch eine kleinere Subgruppe von Patientinnen, bei denen eine Oligometastasierung im Sinne einer singulären oder auf wenige Lokalisationen beschränkten resektablen Metastasierung gefunden wird. Kann die Stabilität der Erkrankung nach einer Phase der systemischen Behandlung bestätigt werden, so kommen lokoregionär wirksame Verfahren wie die chirurgische Metastasenresektion, die Bestrahlung oder die regionale Chemotherapie in Betracht. Zum gegenwärtigen Zeitpunkt liegen keine prospektiv randomisierten Studien vor, die den Nutzen dieser Strategie hinsichtlich des Gesamtüberlebens belegen. Zahlreiche retrospektive Analysen weisen jedoch auf die Effektivität der lokoregionalen Metastasentherapie bei ausgewählten Patientinnen hin und stellen letztlich eine rasche Krankheitskontrolle sowie auch die Möglichkeit des Langzeitüberlebens nach Metastasenresektion in Aussicht.

Abstract

While metastatic breast cancer is a systemic disease in most patients, there is a smaller subset of patients who suffer from oligometastatic disease defined by single or few resectable metastases. After verification of disease stabilization by systemic therapy, locoregional treatment such as surgery or radiation can be applied. While large prospective trials are missing to support the beneficial effect of this strategy, retrospective analyses are highly suggestive offering rapid disease control and even long-term survival in selected patients.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik III, Comprehensive Cancer Center LMU, Klinikum der Universität München, Marchioninistraße 15, 81377, München, Deutschland

    V. Heinemann & H.-J. Stemmler

  2. Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum Großhadern der Universität München, München, Deutschland

    S. Kahlert

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  1. V. Heinemann
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  2. S. Kahlert
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  3. H.-J. Stemmler
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Correspondence to V. Heinemann.

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Heinemann, V., Kahlert, S. & Stemmler, HJ. Multimodale Therapiekonzepte beim metastasierten Mammakarzinom. Internist 51, 1358–1365 (2010). https://doi.org/10.1007/s00108-010-2676-4

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