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Therapie von Gehirnmetastasen

Treatment of brain metastases

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best practice onkologie Aims and scope

Zusammenfassung

Die Inzidenz von Hirnmetastasen nimmt im Zuge immer besserer Möglichkeiten der Behandlung maligner Tumoren zu. Als Primärtumoren werden meistens Bronchialkarzinome, Mammakarzinome und maligne Melanome diagnostiziert. Die Behandlung erfordert ein interdisziplinäres Vorgehen und bemisst sich nach verschiedenen Faktoren wie der Histologie des Primärtumors, der Gesamtprognose, der Anzahl der Hirnmetastasen und der extrazerebralen Metastasierung. Infrage kommen eine Tumorresektion oder Radiochirurgie als lokale Therapie, Ganzhirnbestrahlung als regionaler Therapieansatz, Chemo- oder Immuntherapie als systemische Behandlung sowie supportive Maßnahmen als symptomatischer Behandlungsansatz. Die Indikationsstellung und das Vorgehen werden jeweils näher erläutert. Darüber hinaus erfolgt eine Einordnung des Stellenwerts der Therapieansätze.

Abstract

Due to continually improving treatment options for malignant tumors, the incidence of brain metastases is increasing. Bronchial carcinoma, breast cancer, and malignant melanoma are the most frequently diagnosed primary tumors. Treatment requires an interdisciplinary approach with consideration of various different factors, including primary tumor histology, overall prognosis, the number of brain metastases, and extracerebral metastasis. Possible therapeutic options are tumor resection or radiosurgery as local treatment, whole-brain irradiation as regional treatment, chemo- or immunotherapy as systemic treatment, and best supportive care as a symptomatic treatment approach. Establishment of the indications for each treatment and the subsequent procedures are described in detail. Furthermore, the different treatments are classified according to their value.

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Danksagung

Die Autoren bedanken sich bei PD Dr. med. Gunnar Folprecht für die Beteiligung an der Diskussion über die medikamentöse Therapie.

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Authors and Affiliations

  1. Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland

    Tareq A. Juratli, Johann Klein & Gabriele Schackert

  2. Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland

    Zeinab Khademalhosseini, Mitra Khademalhosseini & Steffen Appold

  3. OncoRay-National Center for Radiation Research in Oncology, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland

    Zeinab Khademalhosseini, Mitra Khademalhosseini & Steffen Appold

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  1. Tareq A. Juratli
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  2. Zeinab Khademalhosseini
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Correspondence to Tareq A. Juratli.

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Interessenkonflikt

T.A. Juratli, Z. Khademalhosseini, M. Khademalhosseini, S. Appold, J. Klein und G. Schackert geben an, dass kein Interessenkonflikt besteht.

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Juratli, T.A., Khademalhosseini, Z., Khademalhosseini, M. et al. Therapie von Gehirnmetastasen. best practice onkologie 12, 72–80 (2017). https://doi.org/10.1007/s11654-017-0014-1

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