Integrative Therapiemöglichkeiten des inoperablen Pankreaskarzinoms – eine Übersicht

 

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Zusammenfassung

In der Behandlung des Adenokarzinoms des Pankreas (PCa) kommt der adjuvanten und palliativen Therapie eine hohe Bedeutung zu. Aufgrund der deutlich limitierten Erfolge der evidenzbasierten Standardtherapie bei PCa mit einer Gemcitabin-Monotherapie oder einer anderen Polychemotherapie sind Alternativen und neuere Therapieansätze gefragt. Es wird eine Übersicht über neue Therapieansätze in der chirurgischen Behandlung und palliative lokale zytostatische und immunologische Therapieverfahren gegeben. Vielversprechend sind eigene Ergebnisse von Studien zu integrativen Therapieansätzen mit Misteltherapie begleitend zur Chemotherapie. Die Misteltherapie zeigt insbesondere positive Effekte auf die Lebensqualität. Chemotherapie bedingte Nebenwirkungen wurden signifikant reduziert, krankheitsbedingte Symptome und Krankenhausaufenthaltszeiten waren deutlich niedriger als mit alleiniger Chemotherapie. Neben der subkutanen Applikation von Mistel zeigt die intratumorale Misteltherapie in der Onkologie eine gute Wirkung. Eine eigene Pilotstudie mit 14 Patienten mit inoperablen PCa am Gemeinschaftskrankenhaus Havelhöhe in Berlin zeigte bei 92 % der Patienten ein lokales Ansprechen bzgl. Tumorreduktion, eine Verlängerung der Überlebenszeit und Erhöhung der Lebensqualität. Weitere Chemotherapie begleitende komplementäre Therapieoptionen wie die Gabe von Antioxidanzien, Vitamin C und E, Selen und Glutathion werden vorgestellt.

Summary

In the treatment of adenocarcinoma of pancreas adjuvante and palliative treatment is of great importance. However the sucess of evidence based standard therapies in pancreatic carcinoma with Gemcitabine-monotherapy or other polychemotherapies are very limited, thus alternatives and innovative treatment options are required. This paper provides an overview of new strategies in surgical treatment and palliative local cytostatic and immunologic therapy options. The results of own studies using integrative approaches with mistletoe concomitant to chemotherapy are promising. Mistletoe therapy exerts positive effects on quality of life, chemotherapy related adverse effects and symptoms due to illness are reduced, time of hospitalization is shortened. Besides subcutaneous application of mistletoe intratumoral application is very effective. An own pilot study in hospital Havelhoehe in Berlin, Germany with 14 patients showed a local response in 92 % of patients concerning tumor reduction, prolongation of survival time and improvement of quality of life. Further complementary therapy options concomitant to chemotherapy like administration of antioxidants, vitamin C and E, selenium and glutathione are presented.

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Korrespondenzadresse

Dr. med. Harald Matthes

Gemeinschaftskrankenhaus Havelhöhe

Kladower Damm 221

14089 Berlin

Email: hmatthes@havelhoehe.de