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Der Onkologe

, Volume 25, Issue 2, pp 171–184 | Cite as

Management des lokal fortgeschrittenen Zervixkarzinoms

  • Christof SchäferEmail author
  • Gabor Galli
  • Carsten Scholz
CME
  • 116 Downloads

Zusammenfassung

Das lokal fortgeschrittene Zervixkarzinom erfordert eine besonders intensive interdisziplinäre Absprache. In der Definition des Stadiums spielen neben der klassischen FIGO-Einteilung (FIGO: „Fédération Internationale de Gynécologie et d’Obstétrique“) Risikofaktoren eine wichtige Rolle. Dabei ist der Lymphknotenstatus entscheidend. In frühen Stadien wird operativ vorgegangen, bei weiter fortgeschrittener Erkrankung bis hin zum Stadium IVA wird die Radiochemotherapie präferiert. In jedem Fall ist eine frühzeitige Besprechung innerhalb eines Tumorboards erforderlich. Kontroversen betreffen z. B. den Einsatz moderner bildgebender Verfahren, die Therapie bei befallenen paraaortalen Lymphknoten, den Stellenwert einer neoadjuvanten Chemotherapie und die Versuche, die klassische Radiochemotherapie mit Cisplatin zu intensivieren. Der Artikel gibt dazu einen Überblick, unter besonderer Berücksichtigung aktueller Studiendaten und unter Bezugnahme auf die derzeit gültigen Leitlinien.

Schlüsselwörter

Zervikale Neoplasmen Risikofaktoren Radiochemotherapie Operative Verfahren Neoadjuvante Therapie 

Management of locally advanced cervical cancer

Abstract

Locally advanced cervical cancer requires particularly intensive interdisciplinary consultation. In addition to the classical FIGO classification (FIGO: Fédération Internationale de Gynécologie et d’Obstétrique), risk factors play an important role in staging. The lymph node status is decisive here. In early stages, surgery is performed; in more advanced cases up to stage IVA, radiochemotherapy is preferred. In all cases, early consultation within a tumor board is necessary. Controversies concern, for example, use of modern imaging techniques, treatment of affected para-aortic lymph nodes, importance of neoadjuvant chemotherapy and attempts to intensify classical radiochemotherapy with cisplatin. The article provides an overview, taking into special consideration current study data and referring to the currently valid guidelines.

Keywords

Neoplasms, cervical Risk factors Chemoradiotherapy Surgical procedures, operative Neoadjuvant therapy 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

C. Schäfer, G. Galli und C. Scholz 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 2019

Authors and Affiliations

  • Christof Schäfer
    • 1
    Email author
  • Gabor Galli
    • 2
  • Carsten Scholz
    • 3
  1. 1.Fachbereich StrahlentherapieMVZ Klinikum Straubing GmbHStraubingDeutschland
  2. 2.Sektion OnkologieKlinikum Straubing GmbHStraubingDeutschland
  3. 3.Klinik für Gynäkologie und GeburtshilfeKlinikum Straubing GmbHStraubingDeutschland

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