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Differenzialtherapie des Prostatakarzinoms

Differential therapy of prostate cancer

  • Schwerpunkt: Was ist gesichert in der Therapie?
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Zusammenfassung

Das Prostatakarzinom hat sich weltweit zur häufigsten Tumorerkrankung der männlichen Bevölkerung entwickelt. Die Standardtherapie zur Behandlung des organbegrenzten Prostatakarzinoms unter kurativer Absicht stellt derzeit die operative Entfernung der Drüse dar. Eine Alternative scheint die Strahlentherapie des Prostatakarzinoms zu bieten, wobei hierfür Langzeitergebnisse ausstehen. Im fortgeschrittenen Erkrankungsstadium kommt die antiandrogene Therapie zum Einsatz, die dem Tumorwachstum den natürlichen Stimulator Testosteron entzieht. Der Einsatz einer Chemotherapie beschränkt sich auf das hormonrefraktäre Krankheitsstadium, ein kurativer Behandlungsansatz besteht dann nicht mehr. Das Standardchemotherapeutikum ist derzeit Doxetacel. Sowohl die Früherkennung, als auch die Tumornachsorge basiert auf der Messung des prostataspezifischen Antigens.

Abstract

Prostate cancer has become the most common malignancy in males worldwide. Standard therapy in local confined prostate cancer with curative intent is a radical ablation of the gland. Brachytherapy seems to be an alternative treatment but long-term results are not yet available. In cases of advanced disease androgen deprivation is applied to eliminate testosterone which is the natural stimulator of tumor growth. The application of chemotherapy is limited to androgen-independent disease without curative intention. Standard chemotherapy is Docetaxel. Both early detection and aftercare are based on measurement of prostate-specific antigen.

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Literatur

  1. Arbeitsgemeinschaft wissenschaftlich medizinischer Fachgesellschaften (2002) S3-Leitlinie: PSA-Bestimmung in der Prostatakarzinomdiagnostik (Früherkennung des Prostatakarzinoms). http://www.awmf-online.de

  2. Arbeitskreis bevölkerungsbezogener Krebsregister in Deutschland, Robert-Koch-Institut (2004) Krebs in Deutschland – Häufigkeiten und Trends, 4. Ausg.

  3. Berger AP, Deibl M, Steiner H et al. (2005) Longitudinal PSA changes in men with or without prostate cancer: assessment of prostate cancer risk. Prostate 64: 240–245

    Article  PubMed  Google Scholar 

  4. Bolla M, Poppel H van, Collette L et al.; European Organization for Research and Treatment of Cancer (2005) Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 366: 572–578

    Article  PubMed  Google Scholar 

  5. Catalona WJ, Smith DS, Ratliff TL, Basler JW (1993) Detection of organic confined prostate cancer is increased through prostate-specific antigen-based screening. JAMA 270: 948–954

    Article  PubMed  CAS  Google Scholar 

  6. Damber JE, Khatami A (2005) Surgical treatment of localized prostate cancer. Acta Oncol 44: 599–604

    Article  PubMed  Google Scholar 

  7. D Ámico AV, Renshaw AA, Cote K (1998) Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 280: 969–974

    Article  Google Scholar 

  8. De Koning HJ, Liem MK, Baan CA et al. (2002) Prostate cancer mortalityreduction by screening: power and time frame with complete enrollment in the European Randomised Screening for Prostate Cancer (ERSCP) trial. Int J Cancer 98: 268–273

    Article  Google Scholar 

  9. Ellis WJ, Chetner MP, Preston SD, Brawer MK (1994) Diagnosis of prostatic carcinoma: the yield of serum prostate specific antigen, digital rectal examination and transrectal ultrasonography. J Urol 152: 1520–1525

    PubMed  CAS  Google Scholar 

  10. Flanigan RC, Catalona WJ, Richie JP (1994) Accuracy of digital rectal examination and transrectal ultrasonography in localizing prostate cancer. J Urol 152: 1506–1509

    PubMed  CAS  Google Scholar 

  11. Gann PH, Hennekens CH, Stampfer MJ (1995) A prospective evaluation of plasma prostate-specific antigen for detection of prostatic cancer. JAMA 273: 289–294

    Article  PubMed  CAS  Google Scholar 

  12. Hoedemaeker RF, Rietbergen JB, Kranse R et al. (2000) Histopathological prostate cancer characteristics at radical prostatectomy after population based screening. J Urol 164: 411–415

    Article  PubMed  CAS  Google Scholar 

  13. Hoelzel D (1991) Epidemiologie des Prostatakarzinoms. Fortschr Med 109: 521–525

    Google Scholar 

  14. Hu JC, Nelson RA, Wilson TG et al. (2006) Perioperative complications of laparoscopic and robotic assisted laparoscopic radical prostatectomy. J Urol 175: 541–546

    Article  PubMed  Google Scholar 

  15. Jager T, Eisenhardt A, Rubben H, Lummen G (2007) Does cigarette smoking influence the survival of patients with prostate cancer? Urologe A 46: 397–400

    Article  PubMed  CAS  Google Scholar 

  16. Loch T, Eppelmann U, Lehmann J et al. (2004) Transrectal ultrasound guided biopsy of the prostate: random sextant versus biopsies of sono-morphologically suspicious lesions. World J Urol 22: 357–360

    Article  PubMed  Google Scholar 

  17. Luboldt HJ, Husing J, Altwein JE et al. (2000) Early detection of prostatic carcinoma in urologic practice with digital rectal examination and prostate-specific antigen. Early Detection Project Group. Urologe A 39: 330–333

    Article  PubMed  CAS  Google Scholar 

  18. Martinez AA, Gonzalez JA, Chung AK (2000) A comparison of external beam radiation therapy versus radical prostatectomy for patients with low risk prostate carcinoma diagnozed, staged and treated at a single institution. Cancer 88: 425–432

    Article  PubMed  CAS  Google Scholar 

  19. Marugame T, Katanoda K (2006) International comparisons of cumulative risk of breast and prostate cancer, from cancer incidence in five continents, vol. VIII. Jpn J Clin Oncol 36: 399–400

    Article  PubMed  Google Scholar 

  20. Messing EM, Manola J, Yao J et al. Eastern Cooperative Oncology Group study EST 3886 (2003) Immediate versus deferred androgen deprivation treatment in patients with node-positive prostate cancer after radical prostatectomy and pelvic lymphadenectomy. Lancet Oncol 7: 472–479

    Article  Google Scholar 

  21. Nagler HM, Gerber EW, Homel P et al. (2005) Digital rectal examination is barrier to population-based prostate cancer screening. Urology 65: 1137–1140

    Article  PubMed  Google Scholar 

  22. Nomura AMY, Kolonel L (1991) Prostate cancer: a current perspective. Am J Epidemiol 13: 200–207

    CAS  Google Scholar 

  23. Parkin DM, Pisani P, Ferlay J (1999) Global Cancer Statistics. CA Cancer J Clin 49: 33–64

    Article  PubMed  CAS  Google Scholar 

  24. Patchell RA, Tibbs PA, Regine WF et al. (2005) Direct decompressive surgical resection in the treatment of spinal cord compression caused by metastatic cancer: a randomised trial. Lancet 366: 643–648

    Article  PubMed  Google Scholar 

  25. Petrylak DP, Tangen CM, Hussain MH et al. (2004) Docetaxel and estramustine compared with mitoxantrone and prednisone for advanced refractory prostate cancer. N Engl J Med 351: 1513–1520

    Article  PubMed  CAS  Google Scholar 

  26. Potter SR, Carter HB (2000) The role of prostate-specific antigen velocity in prostate cancer early detection. Curr Urol Rep 1: 15–19

    Article  PubMed  CAS  Google Scholar 

  27. Sasaki H, Miki J, Hasegawa T et al. (2004) Prostatic cancer in a young adult: a report of two cases. Hinyokika Kiyo 50: 57–59

    PubMed  Google Scholar 

  28. Studer UE, Whelan P, Albrecht W et al. (2006) Immediate or deferred androgen deprivation for patients with prostate cancer not suitable for local treatment with curative intent: European Organisation for Research and Treatment of Cancer (EORTC) Trial 30891. J Clin Oncol 24: 1868–1876

    Article  PubMed  Google Scholar 

  29. Tannock IF, Wit R de, Berry WR et al.; TAX 327 Investigators (2004) Docetaxel plus prednisone or mitoxantrone plus prednisone for advanced prostate cancer. N Engl J Med 351: 1502–1512

    Article  PubMed  CAS  Google Scholar 

  30. Thompson IM Jr, Tangen CM, Paradelo J et al. (2006) Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA 296: 2329–2335

    Article  PubMed  CAS  Google Scholar 

  31. Vashi AR, Wojno KJ, Gillespie B, Oesterling JE (1998) A model for the number of cores per prostate biopsy based on patient age and prostate gland volume. J Urol 159: 920–924

    Article  PubMed  CAS  Google Scholar 

  32. Walsh PC, Partin AW, Epstein JI (1994) Cancer control and quality of life following anatomical radical retropubic prostatectomy: results at 10 years. J Urol 152: 1831–1836

    PubMed  CAS  Google Scholar 

  33. Wirth M, Tyrrell C, Delaere K et al. (2007) Bicalutamide (Casodex) 150 mg plus standard care in early non-metastatic prostate cancer: results from Early Prostate Cancer Trial 24 at a median 7 years‘ follow-up. Prostate Cancer Prostatic Dis 10: 87–93

    Article  PubMed  CAS  Google Scholar 

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  1. Klinik für Urologie, Uroonkologie und Kinderurologie, Universitätsklinikum Essen, Hufelandstraße 55, 45122, Essen, Deutschland

    T. Jäger, H. Rübben & C. Börgermann

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  1. T. Jäger
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  2. H. Rübben
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  3. C. Börgermann
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Correspondence to T. Jäger.

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Jäger, T., Rübben, H. & Börgermann, C. Differenzialtherapie des Prostatakarzinoms. Internist 48, 1382–1388 (2007). https://doi.org/10.1007/s00108-007-1958-y

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  • DOI: https://doi.org/10.1007/s00108-007-1958-y

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