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Strahlentherapie

  • Rolf W. Seiler
Part of the Schriftenreihe Neurologie / Neurology Series book series (NEUROSER, volume 22)

Zusammenfassung

Da die chirurgische Behandlung zur Diagnosestellung, Dekompression und Tumorreduktion an erster Stelle der therapeutischen Maßnahmen steht, wird die Strahlentherapie vorwiegend postoperativ eingesetzt. Deswegen ist sie als alleinige Behandlungsmodalität schwierig beurteilbar, da nach unserem Wissen noch nie eine randomisierte Studie durchgeführt wurde, in welcher die Radiotherapie nach nur stereotaktischer Nadelbiopsie mit der Bestrahlung nach vorangegangener partieller oder totaler Resektion verglichen wurde. Nach unseren Erfahrungen mit der im Kap. IV beschriebenen Pilotstudie, in der die Patienten präoperativ bestrahlt wurden, wäre eine solche Studie wegen der auch mit hochdosierten Steroiden oft nur schwierig kontrollierbaren Hirndrucksteigerung wenig erfolgversprechend. Die Wirkung einer postoperativen Strahlentherapie dagegen ist gut bekannt. Das mittlere progressionsfreie Intervall nach Operation und Nachbestrahlung beträgt rund 6–9 Monate (Tabelle 17) und die mittlere Überlebenszeit 9–12 Monate (Tabelle 16). Auch die Indikation zur postoperativen Strahlentherapie ist heute nicht mehr umstritten. Eine retrospektive Sammelstatistik (116) mit 1258 Patienten, die wegen undifferenzierter Astrozytome operiert oder operiert und bestrahlt wurden, ergab eine Rate klinisch Geheilter von 0,6% (4/649) der allein operierten und von 4% (26/609) der operierten und bestrahlten Patienten.

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© Springer-Verlag Berlin · Heidelberg 1982

Authors and Affiliations

  • Rolf W. Seiler
    • 1
  1. 1.Neurochirurgische Universitätsklinik InselspitalBernSchweiz

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