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Strahlentherapie von malignen Speicheldrüsentumoren

Radiation therapy of malignant salivary gland tumors

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Zusammenfassung

Die Therapie der malignen Speicheldrüsentumoren ist aufgrund der heterogenen Histologie und Lokalisation eine interdisziplinäre Aufgabe. Primär wird die vollständige Resektion des Tumors empfohlen. Eine Radiotherapie (RT) ist postoperativ indiziert bei inkompletter Resektion oder Vorliegen von Risikofaktoren, die für eine aggressive Ausbreitung des Tumors sprechen (u. a. High-Grade-Tumoren, Perineuralscheideninfiltration). Eine definitive RT ist bei inoperablen Tumoren möglich, sollte jedoch bei Möglichkeit einer R0-Resektion hintenangestellt werden. In den letzten Jahren konnte auf dem Gebiet der Radioonkologie durch die Weiterentwicklung moderner Therapieverfahren und den Einsatz der Partikel-RT insbesondere beim adenoidzystischen Karzinom (ACC) bereits eine höhere lokale Kontrollrate oder eine Reduktion der Nebenwirkungen im Vergleich zur konventionellen Photonen-RT beobachtet werden. Aufgrund der biologischen und physikalischen Vorteile sowie erster klinischer Studien ist die Partikel-RT, v. a. mit Kohlenstoffionen, ein vielversprechendes Konzept für die Therapie der Speicheldrüsenkarzinome. Ergebnisse weiterer prospektiver Studien werden erwartet, um den Stellenwert der Partikel-RT in der Therapie der Speicheldrüsentumoren zu stärken.

Abstract

Due to their rarity, histologic heterogeneity, and localization, treatment of malignant salivary gland tumors requires an interdisciplinary approach. First-line treatment includes complete tumor resection. Postoperative radiation therapy is advised in patients with risk factors, i.e., incomplete tumor resection, high-grade tumors, or perineural invasion. Definitive radiation therapy is only advised for inoperable tumors because of significantly lower local control and survival rates when compared to combined surgery and radiation therapy. In radiation oncology, modern techniques such as intensity-modulated radiation therapy (IMRT) or particle therapy with heavy ions (i.e., C12) have led to improved outcomes in the treatment of head and neck tumors, especially of adenoid cystic carcinomas. Given the biological and physical benefits of particles, particle therapy, particularly carbon ion radiation, is a promising therapeutic approach for salivary gland tumors that will be further investigated in prospective clinical studies.

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Authors and Affiliations

  1. Universitätsklinikum Heidelberg (UKHD) und Deutsches Krebsforschungszentrum (DKFZ), Nationales Centrum für Tumorerkrankungen (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Deutschland

    Katharina Weusthof, Jürgen Debus & Sebastian Adeberg

  2. Abteilung für Radioonkologie, Universitätsklinikum Heidelberg (UKHD), Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    Katharina Weusthof, Jürgen Debus & Sebastian Adeberg

  3. Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD und DKFZ, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland

    Katharina Weusthof, Jürgen Debus & Sebastian Adeberg

  4. Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland

    Jürgen Debus

  5. Heidelberger Ionenstrahl-Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Deutschland

    Jürgen Debus

Authors
  1. Katharina Weusthof
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  2. Jürgen Debus
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  3. Sebastian Adeberg
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Correspondence to Katharina Weusthof.

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Interessenkonflikt

K. Weusthof, J. Debus und S. Adeberg geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Weusthof, K., Debus, J. & Adeberg, S. Strahlentherapie von malignen Speicheldrüsentumoren. HNO 71, 243–249 (2023). https://doi.org/10.1007/s00106-022-01188-4

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  • DOI: https://doi.org/10.1007/s00106-022-01188-4

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