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Erschienen in: Die Urologie 7/2009

01.07.2009 | Leitthema

Die Lokaltherapie des Prostatakarzinoms mit thermisch ablativer Energie

verfasst von: Prof. Dr. R. Muschter

Erschienen in: Die Urologie | Ausgabe 7/2009

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Zusammenfassung

Thermische und thermisch ablative Verfahren für die Therapie des Prostatakarzinoms werden – abgesehen von historischen Vorläufern – seit ca. 1980 systematisch untersucht, es wurden zahlreiche experimentelle und klinische Arbeiten publiziert. Dabei kamen verschiedene Techniken zur Anwendung, neben der transurethralen Ablation des Prostatagewebes mit Laser- oder Mikrowellenenergie liegt der Fokus in der interstitiellen Applikation von Laser- oder Mikrowellenstrahlung sowie der induktiven Erwärmung des Gewebes im Magnetfeld nach vorheriger Implantation magnetischer Seeds oder Nanopartikel.
Mit allen genannten Verfahren wurden erste klinische Studien mit insgesamt ca. 350 Patienten behandelt, deren Ergebnisse mangels adäquater Kontrollparameter der älteren Studien und der zu kurzen Nachbeobachtungszeit aller Studien nicht beurteilt werden können. Aussagen zur therapiebedingten Morbidität scheinen möglich und sind durchweg positiv bei geringen Raten schwerwiegender unerwünschter Ereignisse, doch muss hier vor einer Verallgemeinerung die Patientenauswahl berücksichtigt werden, weiterhin der Stand der Technologie zur Zeit der jeweiligen Studien.
Die verschiedenen Publikationen werden ausführlich referiert und zusammenfassend bewertet. Nach Meinung des Autors sind die Ansätze der thermischen und thermisch ablativen Therapie des Prostatakarzinoms interessant, in Anbetracht der vorhandenen Alternativen darf die Machbarkeit jedoch nicht die Sinnhaftigkeit ersetzen.
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Metadaten
Titel
Die Lokaltherapie des Prostatakarzinoms mit thermisch ablativer Energie
verfasst von
Prof. Dr. R. Muschter
Publikationsdatum
01.07.2009
Verlag
Springer-Verlag
Erschienen in
Die Urologie / Ausgabe 7/2009
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-009-1983-7

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