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Die systemische Therapie des metastasierten Prostatakarzinoms

Systemic treatment of metastatic prostate cancer

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Zusammenfassung

Die systemischen Behandlungsmöglichkeiten des fortgeschrittenen Prostatakarzinoms sind vielfältig. Standard ist die Hormontherapie durch Androgendeprivation oder Antiandrogene. Bei Hormonrefraktarität (Kastrationsresistenz) ist Chemotherapie effektiv. Alternative und ergänzende Methoden sind Radionuklide, Steroide und symptomorientierte Maßnahmen. Bisphosphonate werden bei ossärer Metastasierung zur symptomatischen Therapie und zur Prophylaxe von Komplikationen eingesetzt. Die Therapie des Patienten mit metastasiertem Prostatakarzinom ist palliativ. Ziele sind Verlängerung der Überlebenszeit, Verlängerung des krankheitsfreien Überlebens, Symptomlinderung, Verhinderung oder Verzögerung belastender Symptome, Wiederherstellung und Erhalt der Lebensqualität. Die aktuellen verfügbaren Optionen erlauben ein individualisiertes Vorgehen, orientiert an den Zielen und Bedürfnissen des Patienten. Konzeptionell neue Ansätze können das Behandlungsspektrum in absehbarer Zeit deutlich erweitern.

Abstract

Systemic treatment of advanced prostate cancer is multifaceted. First-line therapy is antihormonal treatment with androgen deprivation or antiandrogens. Chemotherapy is effective in hormone refractory (castration resistant) prostate cancer. Alternative and supplementary options include radionuclides, steroids, and symptomatic measures. Use of bisphosphonates is standard in metastatic bone disease. Treatment of patients with metastatic prostate cancer is palliative. The aims are prolongation of overall survival, prolongation of progression-free survival, control and relief of symptoms, and restoration and maintenance of quality of life. Current options allow personalized patient care. New approaches and new drugs will increase the therapeutic possibilities considerably.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehung hin: Sanofi Aventis: Beratung, Referententätigkeit. Trotz des möglichen Interessenkonflikts ist der Beitrag unabhängig und produktneutral.

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Authors and Affiliations

  1. Hämatoonkologische Schwerpunktpraxis Bremen, Parkallee 41–45, 28209, Bremen, Deutschland

    B. Wörmann

  2. Urologische Klinik, Allgemeines Krankenhaus Viersen, Viersen, Deutschland

    J.M. Wolff

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  1. B. Wörmann
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  2. J.M. Wolff
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Correspondence to B. Wörmann.

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Wörmann, B., Wolff, J. Die systemische Therapie des metastasierten Prostatakarzinoms. Urologe 49, 221–227 (2010). https://doi.org/10.1007/s00120-010-2238-3

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