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Erschienen in: Die MKG-Chirurgie 3/2021

25.08.2021 | Brachytherapie | Leitthema

Strategien zur Behandlung von Mundhöhlenkarzinomen

verfasst von: Prof. Dr. Dr. Bernhard Frerich

Erschienen in: Die MKG-Chirurgie | Ausgabe 3/2021

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Zusammenfassung

Für die kurative Behandlung des Mundhöhlenkarzinoms stehen primär chirurgische und nichtchirurgische Therapiestrategien zur Verfügung. In den frühen Stadien ist das alleinige chirurgische Vorgehen Therapie der ersten Wahl und liefert nach derzeitiger Datenlage die günstigsten onkologischen Ergebnisse. Die definitive Strahlentherapie ist eine Alternative für Patienten, die die Operation ablehnen, bei Inoperabilität aus medizinischen Gründen oder bei synchronen Mehrfachkarzinomen. Die Brachytherapie vermeidet die Bestrahlung der Umgebungsgewebe, erfährt ihre Limitationen aber aufgrund der rein lokalen Wirkung. Der Standard für die fortgeschrittenen Stadien ist die primäre Resektion, gefolgt von einer Radiotherapie oder Radiochemotherapie mit Cisplatin je nach Risiko. Obwohl es keine direkt vergleichenden Studien gibt, deuten alle verfügbaren Daten darauf hin, dass das primär chirurgische Vorgehen bei lokoregionär begrenzten Mundhöhlenkarzinomen mehr als bei den anderen Entitäten im Kopf-Hals-Bereich der nicht-chirurgischen Therapie überlegen ist, solange die patientenseitigen Voraussetzungen dafür gegeben sind. Für die nicht oder nicht sinnvoll operablen fortgeschrittenen Mundhöhlenkarzinome, sei es aus allgemeinmedizinischen, funktionellen Gründen oder bei Ablehnung der Operation, ist die simultane Radiochemotherapie mit Hochdosis-Cisplatin der Standard. In der Rezidivsituation müssen die Therapiestrategien immer individuell abgewogen und zugeschnitten werden.
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Metadaten
Titel
Strategien zur Behandlung von Mundhöhlenkarzinomen
verfasst von
Prof. Dr. Dr. Bernhard Frerich
Publikationsdatum
25.08.2021
Verlag
Springer Medizin
Erschienen in
Die MKG-Chirurgie / Ausgabe 3/2021
Print ISSN: 2731-748X
Elektronische ISSN: 2731-7498
DOI
https://doi.org/10.1007/s12285-021-00319-0

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