Der Internist

, Volume 55, Issue 1, pp 31–36 | Cite as

Multimodale Therapie des Pankreaskarzinoms

Schwerpunkt

Zusammenfassung

Adenokarzinome des exokrinen Pankreas gehören zu den aggressivsten soliden Tumorarten und stehen aufgrund der hohen Mortalität an vierter Stelle der häufigsten Tumortodesursachen. Früherkennungsmaßnahmen sind nicht verfügbar. Einzig die radikale, operative Sanierung ist eine kurative Option. Mit adjuvanten Chemotherapiekonzepten lassen sich aktuell mediane Überlebenszeiten von bis zu 23 Monaten erreichen, etwa 25 % der Patienten sind nach 5 Jahren noch am Leben. 75–80 % der Patienten sind bei Erstdiagnose bereits in einer palliativen Therapiesituation. In den letzten 5 Jahren wurden die Therapiemöglichkeiten durch neue Medikamente erweitert. Abhängig vom Allgemeinzustand bei Erstdiagnose können derzeit für Patienten mit metastasiertem Tumorstadium mediane Überlebenszeiten von 6–12 Monaten erreicht werden, weniger als 5 % sind nach 5 Jahren noch am Leben. Neoadjuvante, strahlentherapeutische und immunmodulierende Konzepte haben keinen Stellenwert in der evidenzbasierten klinischen Praxis. Trotz Fortschritten im Verständnis der Tumorbiologie und bezüglich der Therapiemöglichkeiten bleibt das inoperable Pankreaskarzinom eine Erkrankung mit infauster Prognose.

Schlüsselwörter

Risikofaktoren Kurative operative Therapie Palliative Chemotherapie Adjuvante Chemotherapie Prognose 

Multimodal treatment of pancreatic cancer

Abstract

Adenocarcinoma of the exocrine pancreas is one of the most aggressive types of solid tumor and stands at fourth position in the tumor death frequency scale due to a high mortality rate. Effective screening methods are not available and only radical surgery offers a curative option. With adjuvant chemotherapy the median survival time can be prolonged up to 23 months and approximately 25 % of patients are still alive after 5 years. Of these patients approximately 75–80 % are already in a palliative therapy situation at the time of diagnosis. In the last 5 years treatment options have been increased by the introduction of new chemotherapeutic drugs. For patients with metastasized disease median survival times of 6–12 months can currently be achieved depending on the general performance status at diagnosis but less than 5 % of these patients are still alive after 5 years. Neoadjuvant treatment strategies, radiation and immunotherapy do not play a role in evidence-based clinical practice. Despite progress in the understanding of cancer biology and new treatment options, non-resectable adenocarcinoma of the pancreas remains a disease with a very poor prognosis.

Keywords

Risk factors Curative surgical therapy Palliative chemotherapy Chemotherapy, adjuvant Prognosis 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Medizinische Klinik mit Schwerpunkt Hämatologie, Onkologie und TumorimmunologieCharité – Universitätsmedizin Berlin, Campus Virchow-KlinikumBerlinDeutschland

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