Zusammenfassung
Bei metastasierten Harnblasen- und Prostatakarzinomen steht die systemische Therapie sicher im Vordergrund. Durch moderne strahlentherapeutische Verfahren wie die stereotaktische Strahlentherapie, die intensitätsmodulierte Strahlentherapie, die interstitielle Strahlentherapie und die Kombination von Chemotherapie und Strahlentherapie lassen sich effektiv und ohne größere Nebenwirkungen heutzutage Behandlungen im kleinen Becken durchführen. Erste Daten von anderen Organtumoren bzw. retrospektive Auswertungen weisen darauf hin, dass es durch diese Verfahren einen Vorteil hinsichtlich der Lebensqualität, der lokalen Kontrolle und des Gesamtüberlebens der Patientin geben könnte. Derzeit sollte die Indikation zu einer Bestrahlung im Beckenbereich in der metastasierten Situation individuell gestellt werden. Prospektive Untersuchungen insbesondere beim Prostatakarzinom sind derzeit geplant. Im Rahmen dieses Übersichtsartikels werden anhand von Fallbeispielen potentielle Indikationen vorgestellt und anhand einer Literaturübersicht und der Vorstellung prospektiver randomisierter Studien weitere Entwicklungen diskutiert.
Abstract
For metastatic carcinomas of the urinary bladder and prostate, systemic therapy is of primary importance. Due to technological advances in radiation oncology such as stereotactic radiotherapy, intensity-modulated radiotherapy, interstitial radiotherapy, and the combination of radiotherapy and chemotherapy, pelvic irradiation can nowadays be carried out effectively and without the risk of major side effects. New data from other tumor entities and retrospective analyses suggest that the use of these technologies can lead to a clinical benefit in terms of improvement in quality of life, local control, and overall survival. For the time being, the decision to administer radiotherapy to the pelvic region should be made on an individual basis. Retrospective analyses of data from prostate carcinomas in particular are currently being planned. This review article introduces potential indications which are supported with real patient examples and discusses future developments giving an overview of the literature and referring to data from prospective randomized trials.
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Fietkau, R. Wann ist bei metastasiertem Primärtumor und Lymphknotenmetastasen von Harnblase und Prostata eine nicht-operative Behandlung möglich?. Urologe 56, 570–578 (2017). https://doi.org/10.1007/s00120-017-0379-3
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DOI: https://doi.org/10.1007/s00120-017-0379-3
Schlüsselwörter
- Beckentumor
- Strahlentherapie, stereotaktische
- Radiochemotherapie
- Strahlentherapie, interstitielle
- Rezidiv