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Die technischen und methodischen Entwicklungen der Radioonkologie aus ärztlicher Sicht

Technical and methodical developments of radiation oncology from a physician’s point of view

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Zusammenfassung

Technische und methodische Entwicklungen der letzten 40 Jahre haben das Gesicht der Radioonkologie wesentlich verändert. Moderne bildgebende Verfahren, wie Computertomographie (CT), Magnetresonanztomographie (MRI), Positronenemissionstomographie (PET) und Ultraschall haben nicht nur die Erkennbarkeit von Tumoren verbessert, sondern fanden auch Eingang in die computerisierte Bestrahlungsplanung. Die Megavoltbestrahlung mit Photonen und Elektronen aus Beschleunigern mit großen und kleinen Bestrahlungsfeldern, mit Fluenz(Intensitäts)modulation (IMRT), bildgeführter Strahlentherapie (IGRT), stereotaktischer Radiotherapie und Radiochirurgie, intraoperativer Strahlentherapie (IORT) sowie die moderne Brachytherapie im ferngesteuerten Afterloading-Verfahren haben zunehmend Methoden für immer präzisere Strahlenapplikationen bis hin zur Hochpräzisionsbestrahlung zur Verfügung gestellt. Hadronentherapie hat dabei ein weiteres Entwicklungspotential. Die Radioonkologie ist mit diesen Methoden an der Hälfte aller Kurationen beteiligt und hat ein hohes Potenzial in der palliativen Therapie. Die moderne Strahlentherapie ist heute interdisziplinär und berücksichtigt zunehmend Interaktionen mit neuen Medikamenten sowie differenzierten operativen Methoden. Daher besteht ein umfassender Evaluationsbedarf der neuen Methoden wie auch ein hoher Bedarf an translationaler Forschung auf den Gebieten der Tumor- und Normalgewebsbiologie sowie der medizinischen Physik und Technik.

Abstract

Technical and methodical developments have changed radiation oncology substantially over the last 40 years. Modern imaging methods, e.g., computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasound (US), have not only improved the detection of tumors but have also become tools for computed treatment planning. Megavoltage irradiation with accelerators using photons and electrons with large and small fields, intensity modulation (IMRT), image-guided radiotherapy (IGRT), stereotactic irradiation and radiosurgery, intraoperative radiotherapy (IORT), and modern remote controlled afterloading brachytherapy have made high precision radiotherapy increasingly possible. Hadron therapy has potential for further developments. Radiation oncology today is an interdisciplinary modality and increasingly considers interactions with new drugs and differentiated surgical methods. There is a strong need for comprehensive evaluation of the new methods and also for translational research in biology of tumors and normal tissue biology as well as in medical physics and techniques.

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  1. Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Universität Münster, Otto-Hersing-Weg 42, 48167, Münster, Deutschland

    N. Willich

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Willich, N. Die technischen und methodischen Entwicklungen der Radioonkologie aus ärztlicher Sicht. Strahlenther Onkol 188 (Suppl 3), 253–262 (2012). https://doi.org/10.1007/s00066-012-0190-4

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