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„Cancer of unknown primary origin“ – Stellenwert der Strahlentherapie in der multimodalen Behandlung

Cancer of unknown primary—role of radiotherapy in multimodal treatment

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Die Onkologie Aims and scope

Zusammenfassung

Hintergrund

Das CUP-Syndrom („cancer of unknown primary origin“) stellt auch heute noch eine Herausforderung in Diagnostik und Therapie dar. Je nach Lokalisation und Ausdehnung kommen unterschiedliche Therapieverfahren und Therapieabfolgen infrage.

Methoden

Es wurden verschiedene literarische Quellen sowie aktuelle internationale und nationale Therapieempfehlungen zum Stellenwert der Strahlentherapie insbesondere beim CUP-Syndrom ausgewertet.

Ergebnisse

Die Festlegung der Therapie des CUP-Syndrom basiert in erster Linie auf einem optimalen prätherapeutischen Staging. In lokalisierten Stadien wird eine moderne Strahlentherapie bei zervikalen CUP-Syndromen sowohl als eine alleinige Therapieoption als auch postoperativ zur Verbesserung der lokalen Tumorkontrolle eingesetzt. Ähnlich stellt die Strahlentherapie einen zentralen Therapiebaustein in der Behandlung axillärer CUP-Syndrome dar. Bei metastasierten CUP-Syndromen kann eine lokal kurative Bestrahlung einer limitierten Metastasierung sowie eine palliative Bestrahlung zur Symptomlinderung erfolgen.

Schlussfolgerungen

Die Behandlung des CUP-Syndroms sollte interdisziplinär erfolgen. Die Strahlentherapie bietet dabei insbesondere bei der Behandlung des zervikalen und axillären CUP-Syndroms einen kurativen Therapieansatz. Darüber hinaus findet sie Anwendung in fernmetastasierten Erkrankungen zur Symptomkontrolle oder im Rahmen lokaler Metastasentherapie bei oligometastatischen CUP-Syndromen.

Abstract

Background

Treatment of cancer of unknown primary (CUP) remains challenging in terms of pretreatment diagnostics and therapeutic algorithms. Depending on tumor localization and extent, different treatment modalities and sequences can be used.

Methods

Various sources of literature as well as national and international guidelines on radiotherapy for the treatment of CUP were evaluated.

Results

Treatment primarily depends on optimal pretherapeutic staging. For localized disease, modern radiotherapy is commonly employed in the treatment of cervical or axillary CUP, either as a primary treatment or postoperatively to improve locoregional tumor control. For metastasized CUP, ablative stereotactic radiotherapy can be used to treat oligometastases, and palliative radiotherapy is employed for palliation.

Conclusion

Treatment of CUP requires an individualized and interdisciplinary approach. Radiotherapy is commonly employed in the curative treatment of cervical or axillary CUP and can be employed for ablation of limited metastases or for palliation of symptomatic disease.

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Authors and Affiliations

  1. Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Leipzig, Stephanstr. 9A, 04103, Leipzig, Deutschland

    Peter Kurt Hambsch &  Nils Henrik Nicolay

  2. Mitteldeutsches Krebszentrum, Partnerstandort Leipzig, Leipzig, Deutschland

    Peter Kurt Hambsch &  Nils Henrik Nicolay

Authors
  1. Peter Kurt Hambsch
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  2. Nils Henrik Nicolay
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Correspondence to Nils Henrik Nicolay.

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Interessenkonflikt

P.K. Hambsch und N.H. Nicolay geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Hambsch, P.K., Nicolay, N.H. „Cancer of unknown primary origin“ – Stellenwert der Strahlentherapie in der multimodalen Behandlung. Onkologie 30, 196–201 (2024). https://doi.org/10.1007/s00761-024-01479-1

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  • DOI: https://doi.org/10.1007/s00761-024-01479-1

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