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Sekundäre Lebertumoren

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Regionale Tumortherapie

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Zusammenfassung

Wie in Kap. 2 und 3 dargelegt, lässt sich für einige Zytostatika durch die regionale Applikation ein erheblicher Konzentrationsvorteil in der Leber erzielen (Collins 1984). Nach pharmakologischen und pharmakokinetischen Gesichtspunkten ist der regionale Konzentrationsvorteil gerade bei den fluorierten Pyrimidinen Fluordeoxyuridin (FUDR) und 5-Fluorouracil (5-FU) besonders hoch. Da diese Antimetaboliten für lange Zeit die einzigen Zytostatika mit gesicherter Effektivität in der Behandlung fortgeschrittener kolorektaler Karzinome waren, wurden bereits in den 80er-Jahren erste Studien mit direkter Infusion der entsprechenden Zytostatika in die A. hepatica („hepatic artery infusio“, HAI) durchgeführt. Aus technischen Gründen (geringere Lösungsvolumina von FUDR im Vergleich zu 5-FU) wurde anfangs besonders durch Balch und Urist die Dauerinfusion mit FUDR propagiert, die aber die subkutane Implantation sehr teuerer Pumpen erforderlich machte (Balch 1983, 1984). Durch nicht korrekte Darstellung der Ergebnisse wurde der Eindruck sehr hoher Ansprechraten von 88% und eines massiven Anstiegs der überlebensrate nach 1 Jahr erzielt. Die Ansprechrate bezieht sich hier aber nur auf einen Tumormarkerabfall um ein Drittel, und die Verbesserung des überlebens wird durch Vergleich mit einer historischen Kontrollgruppe suggeriert. Da exakte Angaben zur Bestimmung der Größenänderung der Lebermetastasen mittels CT noch völlig fehlten, konnte über die Remissionsraten letztlich keine Aussage gemacht werden (Balch 1983, 1984).

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Authors
  1. A. Schalhorn
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  2. J. Boese-Landgraf
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  3. E. Schmoll
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Editor information

Editors and Affiliations

  1. Klinik für Chirurgie, Klinikum Chemnitz, Flemmingstraße 2, 09116, Chemnitz, Germany

    J. Boese-Landgraf

  2. Chirurgische Klinik, DRK-Krankenhaus Neuwied, Marktstraße 104, 56564, Neuwied, Germany

    Uwe Gallkowski

  3. Zentralinstitut für Diagnostische und Interventionelle Radiologie, Klinikum der Stadt Ludwigshafen, Bremserstraße 79, 67063, Ludwigshafen, Germany

    G. Layer

  4. Medizinische Klinik III, Klinikum Großhadern, Marchioninistraße 15, 81377, München, Germany

    A. Schalhorn

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© 2003 Springer-Verlag Berlin Heidelberg

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Schalhorn, A., Boese-Landgraf, J., Schmoll, E. (2003). Sekundäre Lebertumoren. In: Boese-Landgraf, J., Gallkowski, U., Layer, G., Schalhorn, A. (eds) Regionale Tumortherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-55839-9_11

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  • DOI: https://doi.org/10.1007/978-3-642-55839-9_11

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62602-9

  • Online ISBN: 978-3-642-55839-9

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