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Der Onkologe

, Volume 25, Issue 1, pp 45–52 | Cite as

Strahlentherapie bei Gliomen

Aktuelle Leitlinien und Empfehlungen
  • Ilinca PoppEmail author
  • Jamina T. Fennell
  • Anca-L. Grosu
Leitthema
  • 107 Downloads

Zusammenfassung

Hintergrund

Die Strahlentherapie (RT) ist eine der wichtigen Säulen der Behandlung von Gliomen. Ständig werden neue Studien zum optimalen Bestrahlungszeitpunkt, der Dosierung und Fraktionierung und zur optimalen Kombination mit anderen Therapieformen publiziert.

Ziel

Die aktuellen Leitlinien und Studienergebnisse werden dargestellt und für die klinische Praxis zusammengefasst.

Material und Methode

Eine Literaturrecherche wurde durchgeführt, und die wichtigsten Publikationen und Leitlinien wurden als Grundlage der Empfehlungen für die klinische Praxis genommen.

Ergebnisse

Für die RT von Low-grade-Gliomen (WHO II) beim Erwachsenen ist das individuelle Risikoprofil entscheidend. Für die Patienten mit erhöhtem Rezidivrisiko ist eine frühe adjuvante RT mit 45–54 Gy empfohlen. Patienten mit High-grade-Gliomen sollten dagegen alle eine adjuvante RT mit einer Dosis von 59,4–60 Gy erhalten. Die Zielvolumendefinition und ob eine konkomittante oder adjuvante Chemotherapie notwendig ist, richtet sich nach dem WHO-Grad und der molekularen Diagnostik. Für Patienten in hohem Alter, mit reduziertem Allgemeinzustand und im Fall von Rezidiven gibt es immer mehr gute strahlentherapeutische Optionen.

Schlussfolgerungen

Die RT von Gliomen ist hinsichtlich der Zielvolumendefinition, Dosis und der Kombination mit Chemotherapie maßgeblich auf die WHO-Klassifikation, die molekulare Diagnostik und den klinischen Allgemeinzustand des Patienten ausgerichtet.

Schlüsselwörter

Low-grade-Gliome High-grade-Gliome Hirntumoren Leitlinien WHO-Klassifikation 

Radiation therapy for gliomas

Current guidelines and recommendations

Abstract

Background

Radiotherapy is one of the main therapeutic pillars in the treatment of gliomas. New data on timing of irradiation, radiation dose and fractionation and on the most efficient treatment combination are constantly being published.

Objective

The aim of this article is to present the current guidelines and study results and make a summary for the clinical practice.

Material and methods

A review of the literature was performed, the most important current publications and guidelines were selected and their relevance for the clinical practice is discussed.

Results

The radiotherapy of low-grade gliomas (WHO II) in adults depends on the individual risk profile. In patients with a high risk of recurrence early postoperative irradiation with doses of 45–54 Gy is recommended. In contrast, patients with high-grade gliomas should receive early adjuvant radiotherapy with a dose of 59.4–60 Gy, if their performance status permits it. Target volume definition and the need for concurrent or adjuvant chemotherapy depends on the WHO classification grade and the molecular diagnostics. There are more and more publications about radiotherapy regimen options suited for patients of older age, with low performance scores and in cases of recurrence.

Conclusion

Radiotherapy of gliomas relies heavily on the WHO grading, molecular diagnostics and clinical performance status of the patient for target definition, dose prescription and combination with chemotherapy.

Keywords

Low-grade glioma High-grade glioma Brain tumors Guidelines WHO grading 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

I. Popp, J.T. Fennell und A.-L. Grosu geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2018

Authors and Affiliations

  • Ilinca Popp
    • 1
    • 2
    Email author
  • Jamina T. Fennell
    • 1
    • 2
  • Anca-L. Grosu
    • 1
    • 2
  1. 1.Klinik für Strahlenheilkunde, Universitätsklinikum Freiburg, Medizinische FakultätAlbert-Ludwigs-Universität FreiburgFreiburgDeutschland
  2. 2.Deutsches Konsortium für Translationale Krebsforschung (DKTK), Partnerstandort FreiburgDeutsches Krebsforschungszentrum (DKFZ)HeidelbergDeutschland

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