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Der Stellenwert der Galvanotherapie beim lokal begrenzten Prostatakarzinom

Value of galvanotherapy for localised prostate cancer

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Zusammenfassung

Die therapeutische Anwendung von elektrischem Strom in verschiedenen Bereichen der Medizin wie z. B. Defibrillation im Rahmen der kardiopulmonalen Reanimation, Elektrokrampftherapie (EKT) bei depressiven Erkrankungen oder schmerz- und physiotherapeutischen Behandlung [transkutane elektrische Nervenstimulation (TENS), Diathermie oder Stanger-Bad] ist seit Jahren anerkannt. Die Galvanotherapie im Rahmen der Behandlung von malignen Tumoren wurde in den letzten Jahrzehnten besonders im asiatischen Raum eingehend untersucht. Experimentell wurden die Grundlagen der Galvanotherapie untersucht und verschiedene Theorien der destruierenden Wirkung auf Tumorgewebe aufgestellt. So wird von einer multifaktoriellen Wirkung des Gleichstroms auf das Gewebe ausgegangen, wobei die Verschiebung des pH-Wertes und die Beeinflussung des Membranpotentials der Tumorzellen durch den elektrischen Strom als Hauptwirkmechanismen für die Nekrose der Tumorzellen genannt werden.

In klinischen Studien zeigte die Galvanotherapie bei verschiedenen Tumorentitäten im Vergleich zu den etablierten Therapieoptionen ähnliche Behandlungsergebnisse, wobei teilweise die diesbezüglich publizierten Daten in Hinblick auf das Studiendesign nicht dem international anerkannten wissenschaftlichen Standard entsprechen. Über die Therapie des lokal begrenzten Prostatakarzinoms mit elektrischem Gleichstrom existieren nur sehr beschränkte Daten mit geringen Fallzahlen und umstrittenem Studienaufbau. Laut den aktuellen Richtlinien der EAU (Eurpean Association of Urology) wird diese alternative Therapieoption mit kurativen Ansatz nicht empfohlen und als experimentelle Behandlungsmethode bezeichnet.

Abstract

In recent years electrotherapy has become an accepted treatment option in several medical subfields such as defibrillation during cardiopulmonary resuscitation, electroconvulsive shock treatment (ECT) in conjunction with antidepressant therapy, pain management and physical therapy [transcutaneous electrical nerve stimulation (TENS), diathermia, Stanger bath therapy, etc.]. In recent years several groups, especially from Asia, have investigated the therapeutic effect of electricity in the treatment of malignant tumours. They determined basic principles of electrotherapy and developed different theories of tumour destruction. They postulated a multifactorial tissue effect of continuous current based on tumour cell necrosis due to pH shifting and alteration of membrane potential.

In clinical trials similar oncological results of electrotherapy in several malignant tumours compared to established therapeutic methods were observed, whereas clinical trial designs to some extent were not consistent with internationally accepted scientific standards. Regarding electrotherapy of localised prostate cancer only limited data with a few cases and controversial study designs were published. According to EAU guidelines electrotherapy of localised prostate cancer as an alternative treatment option is not recommended and is still an experimental method. For this procedure well-designed clinical trials and a longer follow-up are mandatory to assess the true role of electrotherapy in the management of prostate cancer.

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  1. Klinik für Urologie, Heinrich-Heine-Universität, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    C. Arsov, C. Winter & P. Albers

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  1. C. Arsov
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  2. C. Winter
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  3. P. Albers
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Correspondence to C. Arsov.

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Arsov, C., Winter, C. & Albers, P. Der Stellenwert der Galvanotherapie beim lokal begrenzten Prostatakarzinom. Urologe 48, 748–754 (2009). https://doi.org/10.1007/s00120-009-1986-4

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