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Chemotherapie des Hodentumors

Chemotherapy of testicular cancer

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Zusammenfassung

Der Einsatz der platinbasierten Polychemotherapie ließ die Heilungsraten beim Hodentumor dramatisch steigen: Zunächst wurde die Chemotherapie in fortgeschrittenen Stadien eingesetzt. Seit einiger Zeit hat sie ihren Platz auch bei niedrigen Stadien gefunden, wobei hier alternative Behandlungsoptionen zur Verfügung stehen. Risikofaktoren können bei der Entscheidungsfindung helfen.

Durch die Kombination von medikamentöser und operativer Therapie können auch in fortgeschrittenen Stadien hohe Heilungsraten erzielt werden. Der Einsatz der Hochdosischemotherapie für Patienten mit schlechter Prognose und Rezidiven befindet sich in der klinischen Prüfung. Der Erfolg korreliert auch hier mit Prognosefaktoren. Patienten mit fortgeschrittenen Stadien eines Nicht-Seminoms benötigen nach der Chemotherapie die Resektion von Resttumorgewebe, wenn es nicht zu einer kompletten Remission gekommen ist.

Der Behandler sollte mit Indikationsstellung und Durchführung der Chemotherapie sowie deren Nebenwirkungen und supportiven Maßnahmen vertraut sein.

Abstract

Platinum-based polychemotherapy has increased the cure rate in testicular cancer dramatically: at first, chemotherapy was mainly used in advanced disease. Recently it has also become common in low-stage disease, though other therapeutic options are equivalent. Risk factors might help to find the right decision.

The success of treatment in patients with metastatic disease results from the combination of chemotherapy and secondary surgery. High-dose chemotherapy for patients with poor prognosis or recurrent disease is being evaluated in clinical trials. Concerning the success in these stages prognostic factors are of special importance. Patients with advanced-stage nonseminoma need residual tumor resection after chemotherapy if no complete remission could be achieved.

The therapist should be aware of the indication for and schedule of chemotherapy, its side effects, and supportive care.

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Authors and Affiliations

  1. Urologische Klinik, Universität, Hufelandstraße 55, 45122, Essen

    S. Krege & H. Rübben

  2. Medizinische Klinik II, Universitätsklinikum, Tübingen

    J. T. Hartmann

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  1. S. Krege
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  2. J. T. Hartmann
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  3. H. Rübben
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Correspondence to S. Krege.

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Krege, S., Hartmann, J.T. & Rübben, H. Chemotherapie des Hodentumors. Urologe 45, 600–604 (2006). https://doi.org/10.1007/s00120-006-1047-1

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  • DOI: https://doi.org/10.1007/s00120-006-1047-1

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