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Photodynamische Therapie

Möglichkeiten und Grenzen bei Kopf-Hals-Karzinomen

■Photodynamic therapy

■Possibilities and limits for head and neck carcinomas

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Der Onkologe Aims and scope

Zusammenfassung

Die photodynamische Therapie (PDT) stellt eine alternative Behandlungsmöglichkeit für Tumoren im Kopf- und Halsbereich dar. Das Prinzip der PDT basiert auf einer photochemischen Reaktion; diese wird durch die Lichtaktivierung einer photosensiblen Substanz vermittelt, die die Tumorzellen abtötet. Das Licht wird meist oberflächlich auf den Tumor und das umgebende Gewebe gestrahlt, sodass der Photosensibilisator aktiviert und die Tumorzellen abgetötet werden. Neue Techniken verwenden Glasfasern, die in den Tumor implantiert werden und so das Licht direkt in den Tumor hineinleiten. Auch die intraoperative Anwendung der PDT zur Behandlung und Beseitigung von zurückgebliebenen Tumorzellen im Bereich der Tumorresektionsränder wurde beschrieben. Nach Durchführung der PDT heilen die Läsionen meist via Regeneration mit nur geringer Narbenbildung ab. Aufgrund dieses organerhaltenden Prinzips werden wichtige Strukturen erhalten und sind gute funktionelle sowie kosmetische Ergebnisse zu erwarten. Neben der kurativen Zielsetzung gewinnt der palliative Einsatz der PDT für die Behandlung von Kopf-Hals-Tumoren zunehmend an Bedeutung. Dieser Artikel befasst sich mit den verschiedenen Möglichkeiten und Grenzen für den klinischen Einsatz der PDT im Kopf-Hals-Bereich.

Abstract

Photodynamic therapy (PDT) is an alternative possible treatment for tumors of the head and neck. The principle of PDT is based on a photochemical reaction caused by the light activation of a photosensitive substance which kills the tumor cells. The light is mostly beamed superficially onto the tumor and surrounding tissue so that the photosensibilizer is activated and the tumor cells are destroyed. New techniques employ glass fibres which are implanted into the tumor to convey the light directly into the tumor. The intraoperative use of PDT for the treatment and removal of residual tumor cells in the margins of resected tumors has also been described. After PDT the lesions heal mostly by regeneration with minimal scar formation. Due to this organ-conserving procedure important structures are retained and good functional and cosmetic results are to be expected. In addition to the curative value, the palliative use of PDT for treatment of head and neck tumors is gaining importance. This article describes the various possibilities and limits for the clinical application of PDT in the head and neck region.

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  1. Klinik und Poliklinik für Mund-, Kiefer-, und Gesichtschirurgie, Universitätsklinikum, 97070, Pleicherwall 2, Würzburg, Deutschland

    A.C. Kübler & T. Reuther

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  1. A.C. Kübler
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  2. T. Reuther
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Correspondence to A.C. Kübler.

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Kübler, A., Reuther, T. Photodynamische Therapie. Onkologe 13, 158–164 (2007). https://doi.org/10.1007/s00761-006-1157-9

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  • DOI: https://doi.org/10.1007/s00761-006-1157-9

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