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01.06.2006 | Leitthema

Nebenwirkungen der Therapie von Hirntumoren

verfasst von: Dr. G. Henke, T. Kucinski, M. Simon, U. Herrlinger

Erschienen in: Die Onkologie | Ausgabe 6/2006

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Zusammenfassung

In der Behandlung von Hirntumoren kommen Operation, Strahlentherapie und Chemotherapie zum Einsatz. Zur Auswahl der Therapie mit einem sinnvollen Verhältnis von Nutzen und Risiko für den Patienten müssen die therapieinduzierten Komplikationen und Nebenwirkungen der einzelnen Behandlungsmodalitäten sowie ihrer Kombination und deren Auswirkung auf die Lebensqualität der Patienten möglichst genau abgeschätzt werden.
Hirntumoroperationen sind Routineeingriffe. Die Operationsmortalität sowie das Risiko für Nachblutungen und lokale Infektionen ist gering. Die Rate persistierender, neuer postoperativer Neurodefizite wird v. a. von der Tumorlokalisation bestimmt und mit 13–26% angegeben. Der Einsatz neuer, intraoperativer Technologien soll helfen, postoperative neurologische Ausfälle zu vermeiden.
Strahlentherapie ist unter Vermeidung großer Bestrahlungsvolumina und hoher Einzeldosen ein sicheres Behandlungsverfahren mit abschätzbarem Risiko. Neben akuten und subakuten Nebenwirkungen ist besonders die Spättoxizität in Form von Nekrose und Enzephalopathie von klinischer Bedeutung. Unter Beachtung der Toleranzgrenzen des gesunden Gehirngewebes und Einsatz moderner Bestrahlungstechniken ist das Risiko für radiogene Spätschäden aber als gering einzustufen.
Behandlung mit systemischer Chemotherapie bringt systemische Nebenwirkungen wie Übelkeit und Erbrechen sowie gelegentlich Therapie limitierende Myelosuppression mit sich. Neben allgemeiner Toxizität einer systemischen Chemotherapie findet sich oft eine toxische Wirkung auf das zentrale und periphere Nervensystem. Kombination von Chemo- mit Strahlentherapie kann zur Verstärkung und Verschiebung der Nebenwirkungen gegenüber der Monotherapie führen.
Literatur
1.
Zurück zum Zitat Abrey LE, DeAngelis LM, Yahalom J (1998) Long-term survival in primary CNS lymphoma. J Clin Oncol 3: 859–863 Abrey LE, DeAngelis LM, Yahalom J (1998) Long-term survival in primary CNS lymphoma. J Clin Oncol 3: 859–863
2.
Zurück zum Zitat Armstrong C, Mollman J, Corn BW et al. (1993) Effects of radiation therapy on adult brain behavior: evidence for a rebound phenomenon in a phase 1 trial. Neurology 10: 1961–1965 Armstrong C, Mollman J, Corn BW et al. (1993) Effects of radiation therapy on adult brain behavior: evidence for a rebound phenomenon in a phase 1 trial. Neurology 10: 1961–1965
3.
Zurück zum Zitat Armstrong CL, Corn BW, Ruffer JE et al. (2000) Radiotherapeutic effects on brain function: double dissociation of memory systems. Neuropsychiatry Neuropsychol Behav Neurol 2: 101–111 Armstrong CL, Corn BW, Ruffer JE et al. (2000) Radiotherapeutic effects on brain function: double dissociation of memory systems. Neuropsychiatry Neuropsychol Behav Neurol 2: 101–111
4.
Zurück zum Zitat Armstrong CL, Gyato K, Awadalla AW et al. (2004) A critical review of the clinical effects of therapeutic irradiation damage to the brain: the roots of controversy. Neuropsychol Rev 1: 65–86CrossRef Armstrong CL, Gyato K, Awadalla AW et al. (2004) A critical review of the clinical effects of therapeutic irradiation damage to the brain: the roots of controversy. Neuropsychol Rev 1: 65–86CrossRef
5.
Zurück zum Zitat Armstrong CL, Hunter JV, Hackney D et al. (2005) MRI changes due to early-delayed conformal radiotherapy and postsurgical effects in patients with brain tumors. Int J Radiat Oncol Biol Phys 1: 56–63CrossRef Armstrong CL, Hunter JV, Hackney D et al. (2005) MRI changes due to early-delayed conformal radiotherapy and postsurgical effects in patients with brain tumors. Int J Radiat Oncol Biol Phys 1: 56–63CrossRef
6.
Zurück zum Zitat Barker FG (1994) Efficacy of prophylactic antibiotics for craniotomy: a meta-analysis. Neurosurgery 3: 484–490 Barker FG (1994) Efficacy of prophylactic antibiotics for craniotomy: a meta-analysis. Neurosurgery 3: 484–490
7.
Zurück zum Zitat Belka C, Budach W, Kortmann RD et al. (2001) Radiation induced CNS toxicity-molecular and cellular mechanisms. Br J Cancer 9: 1233–1239CrossRef Belka C, Budach W, Kortmann RD et al. (2001) Radiation induced CNS toxicity-molecular and cellular mechanisms. Br J Cancer 9: 1233–1239CrossRef
8.
Zurück zum Zitat Borgeat A, De Muralt B, Stalder M (1986) Peripheral neuropathy associated with high-dose Ara-C therapy. Cancer 4: 852–854 Borgeat A, De Muralt B, Stalder M (1986) Peripheral neuropathy associated with high-dose Ara-C therapy. Cancer 4: 852–854
9.
Zurück zum Zitat Brell M, Ibanez J, Caral L et al. (2000) Factors influencing surgical complications of intra-axial brain tumours. Acta Neurochir (Wien) 7: 739–750CrossRef Brell M, Ibanez J, Caral L et al. (2000) Factors influencing surgical complications of intra-axial brain tumours. Acta Neurochir (Wien) 7: 739–750CrossRef
10.
Zurück zum Zitat Brown PD, Buckner JC, Uhm JH et al. (2003) The neurocognitive effects of radiation in adult low-grade glioma patients. Neuro-oncol 3: 161–167 Brown PD, Buckner JC, Uhm JH et al. (2003) The neurocognitive effects of radiation in adult low-grade glioma patients. Neuro-oncol 3: 161–167
11.
Zurück zum Zitat Buckner JC, Gesme D Jr, O’Fallon JR et al. (2003) Phase II trial of procarbazine, lomustine, and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma: efficacy and associations with chromosomal abnormalities. J Clin Oncol 2: 251–255CrossRef Buckner JC, Gesme D Jr, O’Fallon JR et al. (2003) Phase II trial of procarbazine, lomustine, and vincristine as initial therapy for patients with low-grade oligodendroglioma or oligoastrocytoma: efficacy and associations with chromosomal abnormalities. J Clin Oncol 2: 251–255CrossRef
12.
Zurück zum Zitat Butler RW, Hill JM, Steinherz PG et al. (1994) Neuropsychologic effects of cranial irradiation, intrathecal methotrexate, and systemic methotrexate in childhood cancer. J Clin Oncol 12: 2621–2629PubMed Butler RW, Hill JM, Steinherz PG et al. (1994) Neuropsychologic effects of cranial irradiation, intrathecal methotrexate, and systemic methotrexate in childhood cancer. J Clin Oncol 12: 2621–2629PubMed
13.
Zurück zum Zitat Cabantog AM, Bernstein M (1994) Complications of first craniotomy for intra-axial brain tumour. Can J Neurol Sci 3: 213–218 Cabantog AM, Bernstein M (1994) Complications of first craniotomy for intra-axial brain tumour. Can J Neurol Sci 3: 213–218
14.
Zurück zum Zitat Chang SM, Parney IF, McDermott M et al. (2003) Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project. J Neurosurg 6: 1175–1181 Chang SM, Parney IF, McDermott M et al. (2003) Perioperative complications and neurological outcomes of first and second craniotomies among patients enrolled in the Glioma Outcome Project. J Neurosurg 6: 1175–1181
15.
Zurück zum Zitat Chao ST, Suh JH, Raja S et al. (2001) The sensitivity and specificity of FDG PET in distinguishing recurrent brain tumor from radionecrosis in patients treated with stereotactic radiosurgery. Int J Cancer 3: 191–197CrossRef Chao ST, Suh JH, Raja S et al. (2001) The sensitivity and specificity of FDG PET in distinguishing recurrent brain tumor from radionecrosis in patients treated with stereotactic radiosurgery. Int J Cancer 3: 191–197CrossRef
16.
Zurück zum Zitat Combs SE, Widmer V, Thilmann C et al. (2005) Stereotactic radiosurgery (SRS): treatment option for recurrent glioblastoma multiforme (GBM). Cancer 10: 2168–2173CrossRef Combs SE, Widmer V, Thilmann C et al. (2005) Stereotactic radiosurgery (SRS): treatment option for recurrent glioblastoma multiforme (GBM). Cancer 10: 2168–2173CrossRef
17.
Zurück zum Zitat Cowan JA Jr, Dimick JB, Leveque JC et al. (2003) The impact of provider volume on mortality after intracranial tumor resection. Neurosurgery 1: 48–53CrossRef Cowan JA Jr, Dimick JB, Leveque JC et al. (2003) The impact of provider volume on mortality after intracranial tumor resection. Neurosurgery 1: 48–53CrossRef
18.
Zurück zum Zitat Darzy KH, Shalet SM (2005) Hypopituitarism after cranial irradiation. J Endocrinol Invest [Suppl] 5: 78–87 Darzy KH, Shalet SM (2005) Hypopituitarism after cranial irradiation. J Endocrinol Invest [Suppl] 5: 78–87
19.
Zurück zum Zitat de Wit MC, de Bruin HG, Eijkenboom W et al. (2004) Immediate post-radiotherapy changes in malignant glioma can mimic tumor progression. Neurology 3: 535–537 de Wit MC, de Bruin HG, Eijkenboom W et al. (2004) Immediate post-radiotherapy changes in malignant glioma can mimic tumor progression. Neurology 3: 535–537
20.
Zurück zum Zitat Duffau H, Capelle L, Denvil D et al. (2003) Usefulness of intraoperative electrical subcortical mapping during surgery for low-grade gliomas located within eloquent brain regions: functional results in a consecutive series of 103 patients. J Neurosurg 4: 764–778 Duffau H, Capelle L, Denvil D et al. (2003) Usefulness of intraoperative electrical subcortical mapping during surgery for low-grade gliomas located within eloquent brain regions: functional results in a consecutive series of 103 patients. J Neurosurg 4: 764–778
21.
Zurück zum Zitat Dunton SF, Nitschke R, Spruce WE et al. (1986) Progressive ascending paralysis following administration of intrathecal and intravenous cytosine arabinoside. A Pediatric Oncology Group study. Cancer 6: 1083–1088 Dunton SF, Nitschke R, Spruce WE et al. (1986) Progressive ascending paralysis following administration of intrathecal and intravenous cytosine arabinoside. A Pediatric Oncology Group study. Cancer 6: 1083–1088
22.
Zurück zum Zitat Emami B, Lyman J, Brown A et al. (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1: 109–122 Emami B, Lyman J, Brown A et al. (1991) Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 1: 109–122
23.
Zurück zum Zitat Faithfull S, Brada M (1998) Somnolence syndrome in adults following cranial irradiation for primary brain tumours. Clin Oncol (R Coll Radiol) 4: 250–254 Faithfull S, Brada M (1998) Somnolence syndrome in adults following cranial irradiation for primary brain tumours. Clin Oncol (R Coll Radiol) 4: 250–254
24.
Zurück zum Zitat Gerlach R, Scheuer T, Beck J et al. (2003) Risk of postoperative hemorrhage after intracranial surgery after early nadroparin administration: results of a prospective study. Neurosurgery 5: 1028–1034CrossRef Gerlach R, Scheuer T, Beck J et al. (2003) Risk of postoperative hemorrhage after intracranial surgery after early nadroparin administration: results of a prospective study. Neurosurgery 5: 1028–1034CrossRef
25.
Zurück zum Zitat Giglio P, Gilbert MR (2003) Cerebral radiation necrosis. Neurologist 4: 180–188CrossRef Giglio P, Gilbert MR (2003) Cerebral radiation necrosis. Neurologist 4: 180–188CrossRef
26.
Zurück zum Zitat Giorgio CG, Giuffrida D, Pappalardo A et al. (2005) Oral temozolomide in heavily pre-treated brain metastases from non-small cell lung cancer: phase II study. Lung Cancer 2: 247–254CrossRef Giorgio CG, Giuffrida D, Pappalardo A et al. (2005) Oral temozolomide in heavily pre-treated brain metastases from non-small cell lung cancer: phase II study. Lung Cancer 2: 247–254CrossRef
27.
Zurück zum Zitat Glantz MJ, Burger PC, Friedman AH et al. (1994) Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology 11: 2020–2027 Glantz MJ, Burger PC, Friedman AH et al. (1994) Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology 11: 2020–2027
28.
Zurück zum Zitat Gross MW, Altscher R, Brandtner M et al. (2001) Acute toxicity and changes in quality of life during a combined radio-chemotherapy of glioblastomas with topotecan (Hycamtin). Strahlenther Onkol 12: 656–661CrossRef Gross MW, Altscher R, Brandtner M et al. (2001) Acute toxicity and changes in quality of life during a combined radio-chemotherapy of glioblastomas with topotecan (Hycamtin). Strahlenther Onkol 12: 656–661CrossRef
29.
Zurück zum Zitat Hall WA (1998) The safety and efficacy of stereotactic biopsy for intracranial lesions. Cancer 9: 1749–1755CrossRef Hall WA (1998) The safety and efficacy of stereotactic biopsy for intracranial lesions. Cancer 9: 1749–1755CrossRef
30.
Zurück zum Zitat Herrlinger U, Schabet M, Brugger W et al. (2002) German Cancer Society Neuro-Oncology Working Group NOA-03 multicenter trial of single-agent high-dose methotrexate for primary central nervous system lymphoma. Ann Neurol 2: 247–252CrossRef Herrlinger U, Schabet M, Brugger W et al. (2002) German Cancer Society Neuro-Oncology Working Group NOA-03 multicenter trial of single-agent high-dose methotrexate for primary central nervous system lymphoma. Ann Neurol 2: 247–252CrossRef
31.
Zurück zum Zitat Herzig RH, Hines JD, Herzig GP et al. (1987) Cerebellar toxicity with high-dose cytosine arabinoside. J Clin Oncol 6: 927–932 Herzig RH, Hines JD, Herzig GP et al. (1987) Cerebellar toxicity with high-dose cytosine arabinoside. J Clin Oncol 6: 927–932
32.
Zurück zum Zitat Hesketh PJ, Kris MG, Grunberg SM et al. (1997) Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 1: 103–109 Hesketh PJ, Kris MG, Grunberg SM et al. (1997) Proposal for classifying the acute emetogenicity of cancer chemotherapy. J Clin Oncol 1: 103–109
33.
Zurück zum Zitat Hustinx R, Pourdehnad M, Kaschten B et al. (2005) PET imaging for differentiating recurrent brain tumor from radiation necrosis. Radiol Clin North Am 1: 35–47CrossRef Hustinx R, Pourdehnad M, Kaschten B et al. (2005) PET imaging for differentiating recurrent brain tumor from radiation necrosis. Radiol Clin North Am 1: 35–47CrossRef
34.
Zurück zum Zitat Hwang SL, Lin CL, Lee KS et al. (2004) Factors influencing seizures in adult patients with supratentorial astrocytic tumors. Acta Neurochir (Wien) 6: 589–594CrossRef Hwang SL, Lin CL, Lee KS et al. (2004) Factors influencing seizures in adult patients with supratentorial astrocytic tumors. Acta Neurochir (Wien) 6: 589–594CrossRef
35.
Zurück zum Zitat Jahnke K, Korfel A, Martus P et al. (2005) High-dose methotrexate toxicity in elderly patients with primary central nervous system lymphoma. Ann Oncol 3: 445–449CrossRef Jahnke K, Korfel A, Martus P et al. (2005) High-dose methotrexate toxicity in elderly patients with primary central nervous system lymphoma. Ann Oncol 3: 445–449CrossRef
36.
Zurück zum Zitat Keime-Guibert F, Napolitano M, Delattre JY (1998) Neurological complications of radiotherapy and chemotherapy. J Neurol 11: 695–708CrossRef Keime-Guibert F, Napolitano M, Delattre JY (1998) Neurological complications of radiotherapy and chemotherapy. J Neurol 11: 695–708CrossRef
37.
Zurück zum Zitat Kiu MC, Liaw CC, Yang TS et al. (1994) Transient neurological disturbances induced by the chemotherapy of high-dose methotrexate for osteogenic sarcoma. Anticancer Drugs 4: 480–482 Kiu MC, Liaw CC, Yang TS et al. (1994) Transient neurological disturbances induced by the chemotherapy of high-dose methotrexate for osteogenic sarcoma. Anticancer Drugs 4: 480–482
38.
Zurück zum Zitat Klein M, Heimans JJ, Aaronson NK et al. (2002) Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: a comparative study. Lancet 9343: 1361–1368CrossRef Klein M, Heimans JJ, Aaronson NK et al. (2002) Effect of radiotherapy and other treatment-related factors on mid-term to long-term cognitive sequelae in low-grade gliomas: a comparative study. Lancet 9343: 1361–1368CrossRef
39.
Zurück zum Zitat Korinek AM, Golmard JL, Elcheick A et al. (2005) Risk factors for neurosurgical site infections after craniotomy: a critical reappraisal of antibiotic prophylaxis on 4,578 patients. Br J Neurosurg 2: 155–162 Korinek AM, Golmard JL, Elcheick A et al. (2005) Risk factors for neurosurgical site infections after craniotomy: a critical reappraisal of antibiotic prophylaxis on 4,578 patients. Br J Neurosurg 2: 155–162
40.
Zurück zum Zitat Kral T, Kurthen M, Urbach H et al. (2006) The value of mapping higher cortical functions by grid electrodes for resection of gliomas in eloquent brain areas. J Neurosurg (im Druck) Kral T, Kurthen M, Urbach H et al. (2006) The value of mapping higher cortical functions by grid electrodes for resection of gliomas in eloquent brain areas. J Neurosurg (im Druck)
41.
Zurück zum Zitat Laack NN, Brown PD, Ivnik RJ et al. (2005) Cognitive function after radiotherapy for supratentorial low-grade glioma: a North Central Cancer Treatment Group prospective study. Int J Radiat Oncol Biol Phys 4: 1175–1183CrossRef Laack NN, Brown PD, Ivnik RJ et al. (2005) Cognitive function after radiotherapy for supratentorial low-grade glioma: a North Central Cancer Treatment Group prospective study. Int J Radiat Oncol Biol Phys 4: 1175–1183CrossRef
42.
Zurück zum Zitat Latif AZ, Signorini D, Gregor A et al. (1998) The costs of managing patients with malignant glioma at a neuro-oncology clinic. Br J Neurosurg 2: 118–122CrossRef Latif AZ, Signorini D, Gregor A et al. (1998) The costs of managing patients with malignant glioma at a neuro-oncology clinic. Br J Neurosurg 2: 118–122CrossRef
43.
Zurück zum Zitat Leff RS, Thompson JM, Daly MB et al. (1988) Acute neurologic dysfunction after high-dose etoposide therapy for malignant glioma. Cancer 1: 32–35 Leff RS, Thompson JM, Daly MB et al. (1988) Acute neurologic dysfunction after high-dose etoposide therapy for malignant glioma. Cancer 1: 32–35
44.
Zurück zum Zitat Litofsky NS, Farace E, Anderson F Jr et al. (2004) Depression in patients with high-grade glioma: results of the Glioma Outcomes Project. Neurosurgery 2: 358–366CrossRef Litofsky NS, Farace E, Anderson F Jr et al. (2004) Depression in patients with high-grade glioma: results of the Glioma Outcomes Project. Neurosurgery 2: 358–366CrossRef
45.
Zurück zum Zitat Macdonald DR, Kiebert G, Prados M et al. (2005) Benefit of temozolomide compared to procarbazine in treatment of glioblastoma multiforme at first relapse: effect on neurological functioning, performance status, and health related quality of life. Cancer Invest 2: 138–144 Macdonald DR, Kiebert G, Prados M et al. (2005) Benefit of temozolomide compared to procarbazine in treatment of glioblastoma multiforme at first relapse: effect on neurological functioning, performance status, and health related quality of life. Cancer Invest 2: 138–144
46.
Zurück zum Zitat Marquardt G, Setzer M, Lang J et al. (2002) Delayed hydrocephalus after resection of supratentorial malignant gliomas. Acta Neurochir (Wien) 3: 227–231CrossRef Marquardt G, Setzer M, Lang J et al. (2002) Delayed hydrocephalus after resection of supratentorial malignant gliomas. Acta Neurochir (Wien) 3: 227–231CrossRef
47.
Zurück zum Zitat Mott MG, Stevenson P, Wood CB (1972) Methotrexate meningitis. Lancet 7778: 656CrossRef Mott MG, Stevenson P, Wood CB (1972) Methotrexate meningitis. Lancet 7778: 656CrossRef
48.
Zurück zum Zitat Neuloh G, Pechstein U, Cedzich C et al. (2004) Motor evoked potential monitoring with supratentorial surgery. Neurosurgery 5: 1061–1070CrossRef Neuloh G, Pechstein U, Cedzich C et al. (2004) Motor evoked potential monitoring with supratentorial surgery. Neurosurgery 5: 1061–1070CrossRef
49.
Zurück zum Zitat Nimsky C, Ganslandt O, Fahlbusch R (2004) Functional neuronavigation and intraoperative MRI. Adv Tech Stand Neurosurg: 229–263 Nimsky C, Ganslandt O, Fahlbusch R (2004) Functional neuronavigation and intraoperative MRI. Adv Tech Stand Neurosurg: 229–263
50.
Zurück zum Zitat Nuutinen J, Sonninen P, Lehikoinen P et al. (2000) Radiotherapy treatment planning and long-term follow-up with [(11)C]methionine PET in patients with low-grade astrocytoma. Int J Radiat Oncol Biol Phys 1: 43–52CrossRef Nuutinen J, Sonninen P, Lehikoinen P et al. (2000) Radiotherapy treatment planning and long-term follow-up with [(11)C]methionine PET in patients with low-grade astrocytoma. Int J Radiat Oncol Biol Phys 1: 43–52CrossRef
51.
Zurück zum Zitat Pels H, Schmidt-Wolf IG, Glasmacher A et al. (2003) Primary central nervous system lymphoma: results of a pilot and phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol 24: 4489–4495CrossRef Pels H, Schmidt-Wolf IG, Glasmacher A et al. (2003) Primary central nervous system lymphoma: results of a pilot and phase II study of systemic and intraventricular chemotherapy with deferred radiotherapy. J Clin Oncol 24: 4489–4495CrossRef
52.
Zurück zum Zitat Postma TJ, Benard BA, Huijgens PC et al. (1993) Long-term effects of vincristine on the peripheral nervous system. J Neurooncol 1: 23–27CrossRef Postma TJ, Benard BA, Huijgens PC et al. (1993) Long-term effects of vincristine on the peripheral nervous system. J Neurooncol 1: 23–27CrossRef
53.
Zurück zum Zitat Postma TJ, van Groeningen CJ, Witjes RJ et al. (1998) Neurotoxicity of combination chemotherapy with procarbazine, CCNU and vincristine (PCV) for recurrent glioma. J Neurooncol 1: 69–75CrossRef Postma TJ, van Groeningen CJ, Witjes RJ et al. (1998) Neurotoxicity of combination chemotherapy with procarbazine, CCNU and vincristine (PCV) for recurrent glioma. J Neurooncol 1: 69–75CrossRef
54.
Zurück zum Zitat Prados MD, Seiferheld W, Sandler HM et al. (2004) Phase III randomized study of radiotherapy plus procarbazine, lomustine, and vincristine with or without BUdR for treatment of anaplastic astrocytoma: final report of RTOG 9404. Int J Radiat Oncol Biol Phys 4: 1147–1152CrossRef Prados MD, Seiferheld W, Sandler HM et al. (2004) Phase III randomized study of radiotherapy plus procarbazine, lomustine, and vincristine with or without BUdR for treatment of anaplastic astrocytoma: final report of RTOG 9404. Int J Radiat Oncol Biol Phys 4: 1147–1152CrossRef
55.
Zurück zum Zitat Raju U, Gumin GJ, Tofilon PJ (2000) Radiation-induced transcription factor activation in the rat cerebral cortex. Int J Radiat Biol 8: 1045–1053CrossRef Raju U, Gumin GJ, Tofilon PJ (2000) Radiation-induced transcription factor activation in the rat cerebral cortex. Int J Radiat Biol 8: 1045–1053CrossRef
56.
Zurück zum Zitat Rosenblum MK, Delattre JY, Walker RW et al. (1989) Fatal necrotizing encephalopathy complicating treatment of malignant gliomas with intra-arterial BCNU and irradiation: a pathological study. J Neurooncol 3: 269–281 Rosenblum MK, Delattre JY, Walker RW et al. (1989) Fatal necrotizing encephalopathy complicating treatment of malignant gliomas with intra-arterial BCNU and irradiation: a pathological study. J Neurooncol 3: 269–281
57.
Zurück zum Zitat Sawaya R, Hammoud M, Schoppa D et al. (1998) Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors. Neurosurgery 5: 1044–1055CrossRef Sawaya R, Hammoud M, Schoppa D et al. (1998) Neurosurgical outcomes in a modern series of 400 craniotomies for treatment of parenchymal tumors. Neurosurgery 5: 1044–1055CrossRef
58.
Zurück zum Zitat Sawaya R, Zuccarello M, Elkalliny M et al. (1992) Postoperative venous thromboembolism and brain tumors: Part I. Clinical profile. J Neurooncol 2: 119–125 Sawaya R, Zuccarello M, Elkalliny M et al. (1992) Postoperative venous thromboembolism and brain tumors: Part I. Clinical profile. J Neurooncol 2: 119–125
59.
Zurück zum Zitat Schramm J, Aliashkevich AF (2006) Surgery for temporal mediobasal tumors: Experience based on a series of 235 cases. In revision Schramm J, Aliashkevich AF (2006) Surgery for temporal mediobasal tumors: Experience based on a series of 235 cases. In revision
60.
Zurück zum Zitat Schultheiss TE, Kun LE, Ang KK et al. (1995) Radiation response of the central nervous system. Int J Radiat Oncol Biol Phys 5: 1093–1112CrossRef Schultheiss TE, Kun LE, Ang KK et al. (1995) Radiation response of the central nervous system. Int J Radiat Oncol Biol Phys 5: 1093–1112CrossRef
61.
Zurück zum Zitat Shaw E, Arusell R, Scheithauer B et al. (2002) Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. J Clin Oncol 9: 2267–2276CrossRef Shaw E, Arusell R, Scheithauer B et al. (2002) Prospective randomized trial of low- versus high-dose radiation therapy in adults with supratentorial low-grade glioma: initial report of a North Central Cancer Treatment Group/Radiation Therapy Oncology Group/Eastern Cooperative Oncology Group study. J Clin Oncol 9: 2267–2276CrossRef
62.
Zurück zum Zitat Sheline GE, Wara WM, Smith V (1980) Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 9: 1215–1228 Sheline GE, Wara WM, Smith V (1980) Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 9: 1215–1228
63.
Zurück zum Zitat Slevin ML, Piall EM, Aherne GW et al. (1983) Effect of dose and schedule on pharmacokinetics of high-dose cytosine arabinoside in plasma and cerebrospinal fluid. J Clin Oncol 9: 546–551 Slevin ML, Piall EM, Aherne GW et al. (1983) Effect of dose and schedule on pharmacokinetics of high-dose cytosine arabinoside in plasma and cerebrospinal fluid. J Clin Oncol 9: 546–551
64.
Zurück zum Zitat Strojan P, Popovic M, Jereb B (2000) Secondary intracranial meningiomas after high-dose cranial irradiation: report of five cases and review of the literature. Int J Radiat Oncol Biol Phys 1: 65–73CrossRef Strojan P, Popovic M, Jereb B (2000) Secondary intracranial meningiomas after high-dose cranial irradiation: report of five cases and review of the literature. Int J Radiat Oncol Biol Phys 1: 65–73CrossRef
65.
Zurück zum Zitat Stupp R, Mason WP, van den Bent MJ et al. (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 10: 987–996CrossRef Stupp R, Mason WP, van den Bent MJ et al. (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 10: 987–996CrossRef
66.
Zurück zum Zitat Swennen MH, Bromberg JE, Witkamp TD et al. (2004) Delayed radiation toxicity after focal or whole brain radiotherapy for low-grade glioma. J Neurooncol 3: 333–339CrossRef Swennen MH, Bromberg JE, Witkamp TD et al. (2004) Delayed radiation toxicity after focal or whole brain radiotherapy for low-grade glioma. J Neurooncol 3: 333–339CrossRef
67.
Zurück zum Zitat Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3: 159–168CrossRefPubMed Taphoorn MJ, Klein M (2004) Cognitive deficits in adult patients with brain tumours. Lancet Neurol 3: 159–168CrossRefPubMed
68.
Zurück zum Zitat Taphoorn MJ, Schiphorst AK, Snoek FJ et al. (1994) Cognitive functions and quality of life in patients with low-grade gliomas: the impact of radiotherapy. Ann Neurol 1: 48–54CrossRef Taphoorn MJ, Schiphorst AK, Snoek FJ et al. (1994) Cognitive functions and quality of life in patients with low-grade gliomas: the impact of radiotherapy. Ann Neurol 1: 48–54CrossRef
69.
Zurück zum Zitat Taphoorn MJ, Stupp R, Coens C et al. (2005) Health-related quality of life in patients with glioblastoma: a randomised controlled trial. Lancet Oncol 12: 937–944CrossRef Taphoorn MJ, Stupp R, Coens C et al. (2005) Health-related quality of life in patients with glioblastoma: a randomised controlled trial. Lancet Oncol 12: 937–944CrossRef
70.
Zurück zum Zitat Taylor MD, Bernstein M (1999) Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg 1: 35–41 Taylor MD, Bernstein M (1999) Awake craniotomy with brain mapping as the routine surgical approach to treating patients with supratentorial intraaxial tumors: a prospective trial of 200 cases. J Neurosurg 1: 35–41
71.
Zurück zum Zitat Unsgaard G, Gronningsaeter A, Ommedal S et al. (2002) Brain operations guided by real-time two-dimensional ultrasound: new possibilities as a result of improved image quality. Neurosurgery 2: 402–411CrossRef Unsgaard G, Gronningsaeter A, Ommedal S et al. (2002) Brain operations guided by real-time two-dimensional ultrasound: new possibilities as a result of improved image quality. Neurosurgery 2: 402–411CrossRef
72.
Zurück zum Zitat van den Berg H, van der Flier M, van de Wetering MD (2001) Cytarabine-induced aseptic meningitis. Leukemia 4: 697–699 van den Berg H, van der Flier M, van de Wetering MD (2001) Cytarabine-induced aseptic meningitis. Leukemia 4: 697–699
73.
Zurück zum Zitat Verstappen CC, Heimans JJ, Hoekman K et al. (2003) Neurotoxic complications of chemotherapy in patients with cancer: clinical signs and optimal management. Drugs 15: 1549–1563CrossRef Verstappen CC, Heimans JJ, Hoekman K et al. (2003) Neurotoxic complications of chemotherapy in patients with cancer: clinical signs and optimal management. Drugs 15: 1549–1563CrossRef
74.
Zurück zum Zitat Vigliani MC, Sichez N, Poisson M et al. (1996) A prospective study of cognitive functions following conventional radiotherapy for supratentorial gliomas in young adults: 4-year results. Int J Radiat Oncol Biol Phys 3: 527–533CrossRef Vigliani MC, Sichez N, Poisson M et al. (1996) A prospective study of cognitive functions following conventional radiotherapy for supratentorial gliomas in young adults: 4-year results. Int J Radiat Oncol Biol Phys 3: 527–533CrossRef
75.
Zurück zum Zitat Vogel H, Horoupian DS (1993) Filamentous degeneration of neurons. A possible feature of cytosine arabinoside neurotoxicity. Cancer 4: 1303–1308 Vogel H, Horoupian DS (1993) Filamentous degeneration of neurons. A possible feature of cytosine arabinoside neurotoxicity. Cancer 4: 1303–1308
76.
Zurück zum Zitat Vordermark D, Kolbl O, Ruprecht K et al. (2005) Hypofractionated stereotactic re-irradiation: treatment option in recurrent malignant glioma. BMC Cancer 1: 55–61CrossRef Vordermark D, Kolbl O, Ruprecht K et al. (2005) Hypofractionated stereotactic re-irradiation: treatment option in recurrent malignant glioma. BMC Cancer 1: 55–61CrossRef
77.
Zurück zum Zitat Watne K, Hager B, Heier M et al. (1990) Reversible oedema and necrosis after irradiation of the brain. Diagnostic procedures and clinical manifestations. Acta Oncol 7: 891–895 Watne K, Hager B, Heier M et al. (1990) Reversible oedema and necrosis after irradiation of the brain. Diagnostic procedures and clinical manifestations. Acta Oncol 7: 891–895
78.
Zurück zum Zitat Werner-Wasik M, Rudoler S, Preston PE et al. (1999) Immediate side effects of stereotactic radiotherapy and radiosurgery. Int J Radiat Oncol Biol Phys 2: 299–304CrossRef Werner-Wasik M, Rudoler S, Preston PE et al. (1999) Immediate side effects of stereotactic radiotherapy and radiosurgery. Int J Radiat Oncol Biol Phys 2: 299–304CrossRef
79.
Zurück zum Zitat Wick W, Weller M (2005) How lymphotoxic is dose-intensified temozolomide? The glioblastoma experience. J Clin Oncol 18: 4235–4236CrossRef Wick W, Weller M (2005) How lymphotoxic is dose-intensified temozolomide? The glioblastoma experience. J Clin Oncol 18: 4235–4236CrossRef
80.
Zurück zum Zitat Wiedemayer H, Fauser B, Sandalcioglu IE et al. (2002) The impact of neurophysiological intraoperative monitoring on surgical decisions: a critical analysis of 423 cases. J Neurosurg 2: 255–262 Wiedemayer H, Fauser B, Sandalcioglu IE et al. (2002) The impact of neurophysiological intraoperative monitoring on surgical decisions: a critical analysis of 423 cases. J Neurosurg 2: 255–262
81.
Zurück zum Zitat Zentner J, Meyer B, Stangl A et al. (1996) Intrinsic tumors of the insula: a prospective surgical study of 30 patients. J Neurosurg 2: 263–271 Zentner J, Meyer B, Stangl A et al. (1996) Intrinsic tumors of the insula: a prospective surgical study of 30 patients. J Neurosurg 2: 263–271
Metadaten
Titel
Nebenwirkungen der Therapie von Hirntumoren
verfasst von
Dr. G. Henke
T. Kucinski
M. Simon
U. Herrlinger
Publikationsdatum
01.06.2006
Verlag
Springer-Verlag
Erschienen in
Die Onkologie / Ausgabe 6/2006
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-006-1053-3

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