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Erschienen in: Die Ophthalmologie 2/2020

06.12.2019 | Basalzellkarzinom | Leitthema

Alternative Behandlungsoptionen beim Basalzellkarzinom am Auge

verfasst von: PD Dr. med. Vinodh Kakkassery, Steffen Emmert, Irenäus A. Adamietz, György Kovács, Anselm M. Jünemann, Caroline Otte, Michael Zimbelmann, Anton Brosig, Salvatore Grisanti, Ludwig M. Heindl

Erschienen in: Die Ophthalmologie | Ausgabe 2/2020

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Zusammenfassung

Hintergrund

Neuste Entwicklungen, aber auch ältere Verfahren bieten, soweit die mikrographisch kontrollierte Chirurgie nicht zum Einsatz kommen kann, alternative Therapieverfahren beim Basalzellkarzinom an.

Ziel

Dargestellt werden alternative Therapieoptionen bei periokulären Basalzellkarzinomen.

Methoden

Es erfolgen eine Literaturrecherche sowie eine strukturierte Darstellung und Bewertung der Ergebnisse.

Ergebnisse

Die mikrographisch kontrollierte Chirurgie ist der Goldstandard der Therapie der Basalzellkarzinome. Wenn die Chirurgie aus verschiedensten Gründen nicht erfolgen kann, werden andere Verfahren benötigt. Die alternativen Behandlungsoptionen beim Basalzellkarzinom lassen sich in 3 Gruppen unterteilen: Behandlungsoptionen für lokal fortgeschrittene Basalzellkarzinome bzw. für metastasierte Basalzellkarzinome, topische Verfahren für kleine und oberflächliche Basalkarzinome sowie prophylaktische Maßnahmen. Während die Bestrahlung und die Systemtherapie bei lokal fortgeschrittenen Basalzellkarzinomen Sinn ergeben und im Tumorboard besprochen werden, können kleine und oberflächliche Befunde topisch behandelt werden. Eine Prophylaxe kann bei einer vorherigen Basalzellkarzinomhistorie durchgeführt werden. Gerade Systemtherapiekombinationen, aber auch ein neoadjuvanter oder adjuvanter Ansatz vor oder nach der Chirurgie sind weitere Erfolg versprechende Möglichkeiten, die beim lokal fortgeschrittenen Basalzellkarzinom den Behandlungsstandard weiter verbessern können.

Schlussfolgerung

Alternative Behandlungsoptionen beim periokulären Basalzellkarzinom existieren. Allerdings ist deren Einsatz ausschließlich indiziert, wenn die mikroskopisch kontrollierte Exzision mit anschließender okuloplastischer Rekonstruktion nicht möglich ist. Nahezu zwingend nach den nationalen Leitlinien ist eine vorherige Vorstellung in einem geeigneten Tumorboard.
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Metadaten
Titel
Alternative Behandlungsoptionen beim Basalzellkarzinom am Auge
verfasst von
PD Dr. med. Vinodh Kakkassery
Steffen Emmert
Irenäus A. Adamietz
György Kovács
Anselm M. Jünemann
Caroline Otte
Michael Zimbelmann
Anton Brosig
Salvatore Grisanti
Ludwig M. Heindl
Publikationsdatum
06.12.2019
Verlag
Springer Medizin
Erschienen in
Die Ophthalmologie / Ausgabe 2/2020
Print ISSN: 2731-720X
Elektronische ISSN: 2731-7218
DOI
https://doi.org/10.1007/s00347-019-01021-4

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