Zusammenfassung
Innerhalb des zentralen und peripheren Nervensystems entwickelt sich eine große Vielzahl von Tumoren mit sehr unterschiedlicher Inzidenz, Altersbevorzugung und Prognose. Zudem ist das Nervensystem sehr häufig von der Metastasierung systemischer Tumorerkrankungen betroffen. Die wesentlichen Therapiemodalitäten sind die Operation, die Strahlentherapie mit verschiedenen Konzepten der Fraktionierung, der Gesamtdosis und des Zielvolumens sowie verschiedene Ansätze der Chemotherapie wie systemische, interstitielle und intrathekale Chemotherapie und Hochdosischemotherapie mit Stammzelltransplantation. Dass viele dieser Therapieansätze nicht mehr nur einen palliativen, sondern einen kurativen Therapieansatz verfolgen, verdeutlicht, dass in der Neuroonkologie derzeit viele klassische Therapiekonzepte überdacht und innovative Strategien in die Therapie eingeführt werden.
Abstract
The central and peripheral nervous systems give rise to a variety of tumors which differ markedly in their incidence, age preference, and prognosis. The nervous system is also frequently affected by metastatic cancer. The major therapeutic options for tumors of the nervous system include surgical resection, radiotherapy using various strategies of fractionation, total dose, and target volume, and different approaches of chemotherapy such as systemic, intrathecal, and interstitial chemotherapy as well as high-dose chemotherapy with stem cell rescue. An increasing number of therapeutic options in neurooncology are no more merely palliative treatments, but may be curative, indicating that neurooncology is experiencing an era both of controversies regarding previous standards of care and of innovative strategies to combat tumors of the nervous system.
Literatur
Brandt T, Dichgans J, Diener HC (2003) Therapie und Verlauf neurologischer Erkrankungen. Kohlhammer, München
Davis FG, McCarthy BJ, Freels S et al. (1999) The conditional probability of survival of patients with primary malignant brain tumors. Surveillance, epidemiology, and end results (SEER) data. Cancer 85:485–491
DeAngelis LM (2001) Brain tumors. N Engl J Med 344:114–122
Diener HC, Hacke W (2003) Leitlinien der Deutschen Gesellschaft für Neurologie. Thieme, Stuttgart
Glioma Meta-analysis Trialists (GMT) Group (2002) Chemotherapy in adult high-grade glioma: a systematic review and meta-analysis of individual patient data from 12 randomised trials. Lancet 359:1011–1018
Herrlinger U, Felsberg J, Küker W et al. (2002) Gliomatosis cerebri. Molecular pathology and clinical course. Ann Neurol 52:390–399
Herrlinger U, Schabet M, Brugger W et al. (2002) German cancer society neuro-oncology group NOA-03 multicenter trial of single-agent high-dose methotrexate for primary central nervous system lymphoma. Ann Neurol 51:247–252
Karim AB, Afra D, Cornu P et al. (2002) Randomized trial on the efficacy of radiotherapy for cerebral low-grade glioma in the adult: European Organization for Research and Treatment of Cancer Study 22845 with the Medical Research Council study BRO4: an interim analysis. Int J Radiat Oncol Biol Phys 52:316–324
Kleihues P, Cavenee WK (2000) World Health Organization classification of tumours. Pathology & genetics. Tumours of the nervous system. IARC Press, Lyon
Kondziolka D, Lunsford D, McLaughlin MR, Flickinger JC (1998) Long-term outcomes after radiosurgery for acoustic neuromas. N Engl J Med 339:1426–1433
Macdonald DR, Cascino TL, Schold SC, Cairncross JG (1990) Response criteria for phase II studies of supratentorial malignant glioma. J Clin Oncol 8:1277-1280
Neuro-Oncology Oncology Group (NOA) of the German Cancer Society (2003) Neuro-Oncology Working Group (NOA)-01 trial of radiotherapy plus adjuvant ACNU/VM26 versus ACNU/Ara-C chemotherapy for malignant glioma. J Clin Oncol 21:3276–3284
Pels H, Schmidt-Wolf IGH, Glasmacher A et al. (in press) Primary CNS lymphoma: Results of a pilot/phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol
Reifenberger G, Louis DN (2003) Oligodendroglioma: toward molecular definitions in diagnostic neuro-oncology. J Neuropathol Exp Neurol 62:111–126
Schlegel U, Weller M, Westphal M (2003) Neuro-Onkologie. Thieme, Stuttgart
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Weller, M. Neuroonkologie. Nervenarzt 74, 1139–1149 (2003). https://doi.org/10.1007/s00115-003-1645-8
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DOI: https://doi.org/10.1007/s00115-003-1645-8