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Strahlentherapie des Prostatakarzinoms in der neuen S3-Leitlinie

Teil 1: Lokal begrenztes und lokal fortgeschrittenes Prostatakarzinom

Radiation therapy for prostate cancer in the new S3 guideline

Part 1: localized and locally advanced prostate cancer

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Zusammenfassung

Die Strahlentherapie ist eine Therapieoption zur kurativen Behandlung des lokal begrenzten und des lokal fortgeschrittenen Prostatakarzinoms. Abhängig vom Tumorstadium und der Konstellation der Risikofaktoren (PSA-Wert, Tastbefund und Gleason-Score) werden unterschiedliche Formen der Strahlentherapie angewandt. Bei Patienten mit niedrigen Risikofaktoren und in frühen klinischen Stadien wird neben der alleinigen perkutanen Strahlentherapie auch die alleinige Brachytherapie mit radioaktiven Seeds eingesetzt. Mit zunehmendem Rezidivrisiko ist eine Intensivierung der Therapie angezeigt. Diese kann durch zusätzlichen Einsatz einer medikamentösen hormonablativen Therapie und/oder eine Intensivierung der Strahlentherapie (Dosiseskalation) erfolgen. Auch Kombinationsbehandlungen von Brachytherapie und perkutaner Strahlentherapie werden hier eingesetzt. Bei Einsatz einer hormonablativen Therapie sollte diese, abhängig vom Rezidivrisiko, über einen Zeitraum von 3–36 Monaten als neoadjuvante und/oder adjuvante Behandlung appliziert werden.

Abstract

Radiation therapy is a treatment option for curative management of localized and locally advanced prostate cancer. Depending on tumor stage and constellation of risk factors (PSA level, findings on digital rectal examination, and Gleason score), various forms of radiotherapy are applied. In addition to the sole use of external beam radiotherapy, brachytherapy with radioactive seeds is also employed as stand-alone treatment in patients with low risk factors and in early clinical stages. Increasing risk of recurrence requires more intensive therapies which can be accomplished by adding hormone deprivation therapy and/or intensifying radiation therapy (dose escalation). Combined approaches using brachytherapy and percutaneous radiotherapy are also initiated in these cases. If hormone ablation therapy is administered, this should occur over a course of 3–36 months as neoadjuvant, concommitant and/or adjuvant treatment, depending on the risk of recurrence.

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Authors and Affiliations

  1. Klinik für Strahlentherapie, Charité-Universitätsmedizin Berlin, Campus-Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland

    D. Böhmer

  2. Radioonkologie, Universitätsklinikum Mannheim, Mannheim, Deutschland

    F. Wenz

  3. Praxisgemeinschaft für Strahlentherapie und Radioonkologie, Bremen, Deutschland

    T. Martin

  4. Klinik für Radiotherapie und Radio-Onkologie, Salzburger Landeskliniken, Salzburg, Österreich

    F. Sedlmayr

  5. Klinik für Radioonkologie und Strahlentherapie, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland

    W. Hinkelbein

  6. Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Ulm, Ulm, Deutschland

    T. Wiegel

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  1. D. Böhmer
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  2. F. Wenz
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  3. T. Martin
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  4. F. Sedlmayr
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  6. T. Wiegel
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Correspondence to D. Böhmer.

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Böhmer, D., Wenz, F., Martin, T. et al. Strahlentherapie des Prostatakarzinoms in der neuen S3-Leitlinie. Urologe 49, 211–215 (2010). https://doi.org/10.1007/s00120-010-2241-8

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  • DOI: https://doi.org/10.1007/s00120-010-2241-8

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