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01.07.2009 | Leitthema

Externe Strahlentherapie zur Schmerzkontrolle

Am Beispiel von Knochenmetastasen

verfasst von: Prof. Dr. D. Rades

Erschienen in: Die Onkologie | Ausgabe 7/2009

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Zusammenfassung

Knochenmetastasen sind die häufigste Ursache von Tumorschmerzen. Sie können sehr effektiv und nebenwirkungsarm mit einer Strahlentherapie behandelt werden. Laut bisherigen Daten weist die Einzeitbestrahlung (1-mal 8 Gy) eine ebenso effektive analgetische Wirkung wie fraktionierte Regimes auf, ist jedoch häufiger von einem Schmerzrezidiv gefolgt, das dann aber problemlos und nebenwirkungsarm erneut strahlentherapeutisch behandelt werden kann. Somit wird das Schema 1-mal 8 Gy weltweit als Standardtherapie unkomplizierter schmerzhafter Knochenmetastasen angesehen. Ist auch eine Remineralisierung der betroffenen Knochenareale erwünscht, führen eine fraktionierte Kurzzeit- (6-mal 4 Gy) oder eine Langzeitbestrahlung (10-mal 3 Gy oder 20-mal 2 Gy) zu signifikant besseren Resultaten als 1-mal 8 Gy. Gemäß aktueller Daten ist die Einzeitbestrahlung bei metastatisch bedingter Rückenmarkkompression hinsichtlich der motorischen Funktion ähnlich effektiv wie fraktionierte Kurzzeit- oder Langzeitregimes. Jedoch sind Rezidive nach Langzeitbestrahlung deutlich seltener. Da die Remineralisierung von Knochenmetastasen sowie Rezidive bei metastatisch bedingter Rückenmarkkompression erst Monate nach der Bestrahlung auftreten, ist eine Langzeitbestrahlung bei Patienten mit besserer Überlebensprognose indiziert.
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Metadaten
Titel
Externe Strahlentherapie zur Schmerzkontrolle
Am Beispiel von Knochenmetastasen
verfasst von
Prof. Dr. D. Rades
Publikationsdatum
01.07.2009
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 7/2009
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-009-1629-9

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