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24.01.2018 | Sarkome | Leitthema

Stellenwert der isolierten Extremitätenperfusion bei Sarkomen

verfasst von: Dr. med. L. E. Podleska, F. Farzaliyev, G. Täger

Erschienen in: Die Onkologie | Ausgabe 3/2018

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Zusammenfassung

Hintergrund und Ziel

Die isolierte Extremitätenperfusion mit Tumornekrosefaktor-α (TNF-α) und Melphalan (TM-ILP [ILP: „isolated limb perfusion“]) ist eines der wirksamsten Therapieverfahren zur neoadjuvanten Therapie von nicht resektablen Weichgewebesarkomen der Extremitäten. Diese Übersichtsarbeit beschreibt die Zusammenhänge und Wirkungsweise der TM-ILP, v. a. im Hinblick auf die Einhaltung der Sicherheitsabstände und die Möglichkeiten der TM-ILP, diese durch Devitalisierung der Tumorzellen in den Randbereichen bzw. den zukünftigen Resektionsrändern zu verbessern.

Methoden

Es wurden eine Recherche und Auswertung aktueller Literatur durchgeführt.

Ergebnisse

Durch die Vorbehandlung mittels TM-ILP kann eine sonst notwendige Amputation in 80 % der Fälle vermieden werden. Im Rahmen eines kurativen, multimodalen Therapieansatzes kann der Tumor nach der initialen TM-ILP 6–8 Wochen später mit knappen Sicherheitsabständen unter Erhalt der Extremität entfernt werden. Auch in palliativer Therapieintention kann die TM-ILP Anwendung finden. Hierdurch kann, insbesondere in Kombination mit einer anschließenden systemischen Chemotherapie, ein längerfristiger Wachstumsarrest des Tumors erreicht werden. In Kombination mit einer anschließenden Strahlentherapie kann dieser Effekt noch verstärkt werden.

Schlussfolgerung

Trotz der bestehenden Amputationsindikation zeigen Patienten nach ILP hervorragende Lebensqualität, die auch im längerfristigen Verlauf konstant bleibt.
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Metadaten
Titel
Stellenwert der isolierten Extremitätenperfusion bei Sarkomen
verfasst von
Dr. med. L. E. Podleska
F. Farzaliyev
G. Täger
Publikationsdatum
24.01.2018
Verlag
Springer Medizin
Schlagwörter
Sarkome
Weichteilsarkome
Erschienen in
Die Onkologie / Ausgabe 3/2018
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-017-0328-1

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