Zusammenfassung
Die peritoneale Dissemination von Tumorzellen ist bei zahlreichen Tumorentitäten von entscheidender prognostischer Bedeutung – sowohl in der Limitation der Möglichkeit einer Heilung als auch als Manifestation einer Metastasierung. Da der peritoneale Befall häufig mit schwerwiegenden klinischen Symptomen verbunden ist, die eine Einschränkung der Lebensqualität zur Folge haben, ist ein optimales Management erforderlich, bei dem die systemische Chemotherapie eine entscheidende Rolle spielt – insbesondere, da sie ein wesentlicher Teil der Behandlungsstrategie bei systemisch metastasierten Tumorerkrankungen ist. Auch wenn davon auszugehen ist, dass sich die Wirkung der Systemtherapie zwischen den verschiedenen Lokalisationen nicht wesentlich unterscheidet, lässt die Datenlagen keine eindeutige Einschätzung über die Wirkung bei ausschließlich peritonealen Manifestationen zu. Neue systemische Substanzen sowie deren Verwendung in multimodalen Konzepten (systemische Chemotherapie, intraperitoneale Therapie plus chirurgische Zytoreduktion) müssen daher in klinische Studien integriert werden.
Abstract
Peritoneal metastases are common in metastatic disease of many tumour types and thus are determinant for prognosis and development of tumour-related symptoms that jeopardise quality of life. Systemic chemotherapy has proven efficacious in improving both prognosis and quality of life in numerous tumour types and should therefore be considered as part of the treatment strategy – although there is no large body of data from predefined cohorts with“only peritoneal” manifestation. In further clinical trials therefore, improvement of systemic chemotherapy by integration of novel agents should be implemented in multimodal treatment approaches combining systemic treatment, cytoreductive surgery, and intraperitoneal treatment strategies.
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Der korrespondierende Autor weist auf folgende Beziehung/en hin: Referententätigkeit für Pfizer, Roche, Merck, Sanofi-Aventis.
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Arnold, D., Lordick, F. Systemische Behandlungsmöglichkeiten der Peritonealkarzinose. Chirurg 78, 1117–1122 (2007). https://doi.org/10.1007/s00104-007-1435-0
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DOI: https://doi.org/10.1007/s00104-007-1435-0