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Ganzkörperbestrahlung

Rolle und Indikationsspektrum

Total body irradiation

Role and indications

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Durch die Entwicklung von Hochdosiskonzepten mit nachfolgender Blutstammzelltransplantation konnte eine Kuration ansonsten letal verlaufender Erkrankungen des hämatopoetischen Systems erreicht werden. Bereits bei den initialen Behandlungskonzepten war die Ganzkörperkörperbestrahlung ein essenzieller Therapiebestandteil der Konditionierung vor allogener Transplantation. Das Indikationsspektrum umfasst v. a. akute Leukämien, chronisch-myeloische Leukämie, myelodysplastisches Syndrom und Non-Hodgkin-Lymphome. Die bisher durchgeführten Hochdosiskonzepte wurden in den vergangenen Jahren aufgrund der hohen Toxizität zunehmend durch dosisreduzierte Konzepte (RIC) ersetzt, die v. a. bei älteren Patienten bzw. bei Patienten mit Komorbiditäten zum Einsatz kommen. Der Stellenwert der verschiedenen RIC-Protokolle mit und ohne Beteiligung der Ganzkörperbestrahlung sowie das exakte Indikationsspektrum sind noch weitgehend unklar.

Abstract

The development of high-dose therapy regimens with subsequent HSCT was a breakthrough in the treatment of otherwise lethal diseases of the hematopoietic system. Initially, TBI was an essential part of the conditioning regimen prior to allogeneic transplantation. Major indications for the use of TBI are ALL, AML, CML, MDS, and non-Hodgkin’s lymphomas. Since myeloablative conditioning regimens are associated with severe side effects, in recent years several reduced-intensity regimens have been increasingly employed, especially in older patients/patients with comorbidities due to a favorable toxicity profile. The significance of these reduced-intensity concepts with/without the use of TBI and the indications are still largely unclear.

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Authors and Affiliations

  1. Klinik für Radioonkologie, Universitätsklinik Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, -

    F. Heinzelmann &  C. Belka

  2. Medizinische Klinik II, Universitätsklinik Tübingen, -, -

    C. Faul

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  1. F. Heinzelmann
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  2. C. Faul
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  3. C. Belka
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Correspondence to C. Belka.

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Heinzelmann, F., Faul, C. & Belka, C. Ganzkörperbestrahlung. Onkologe 13, 397–408 (2007). https://doi.org/10.1007/s00761-006-1089-4

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