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01.02.2014 | Leitthema

Tumorrezidive der Kopf-Hals-Region nach Primärtherapie

verfasst von: Dr. T. Gauler, V. Grünwald

Erschienen in: Die Onkologie | Ausgabe 2/2014

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Zusammenfassung

Hintergrund

Die palliative Systemtherapie von Patienten mit Kopf-Hals-Tumoren ist für die medizinische Onkologie seit Jahrzehnten eine Herausforderung. Im letzten Jahrhundert gelangen trotz Einführung der platinbasierten Kombinationschemotherapie keine richtungsweisenden Fortschritte.

Fragestellung

Können neue Substanzen, insbesondere zielgerichtete Präparate, einen signifikanten klinischen Benefit herbeiführen?

Material und Methode

Es wurde eine Analyse kontrollierter klinischer Studien anhand von Publikationen und Präsentationen durchgeführt. Die S3-Leitlinie Mundhöhlenkarzinom wurde ausgearbeitet und translationale Arbeiten und Expertenempfehlung diskutiert.

Ergebnisse

Cetuximab zur platinbasierten Kombinationschemotherapie ist seit dem Jahr 2008 der neue Standard in der Erstlinienbehandlung des Kopf-Hals-Tumors bei recht gutem Verträglichkeitsprofil und erhaltener Lebensqualität. Bisher gibt es keine prädiktiven Faktoren, die einen selektionierten Einsatz dieser Kombination befürworten. Allerdings sollte man bei Patienten in reduziertem Allgemeinzustand bzw. bei Komorbidität eine Monotherapie vorziehen. Beim erneuten Rezidiv bzw. Progress unter dieser Behandlung sollten monotherapeutische Konzepte mit gängigen Zytostatika wie Taxanen oder Methotrexat erwogen werden.

Schlussfolgerungen

Cetuximab in Kombination mit platinhaltiger Chemotherapie sollte die 1. Wahl in der Erstlinientherapie sein. Bei Progress ist eine Monotherapie zu empfehlen.
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Metadaten
Titel
Tumorrezidive der Kopf-Hals-Region nach Primärtherapie
verfasst von
Dr. T. Gauler
V. Grünwald
Publikationsdatum
01.02.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Onkologie / Ausgabe 2/2014
Print ISSN: 2731-7226
Elektronische ISSN: 2731-7234
DOI
https://doi.org/10.1007/s00761-013-2587-9

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