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01.05.2009 | Leitthema

Strahlen-, Chemo- und Targettherapie von Kopf-Hals-Karzinomen

Neue Entwicklungen

verfasst von: Prof. Dr. R. Knecht

Erschienen in: HNO | Ausgabe 5/2009

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Zusammenfassung

Bei etwa 60% der erstmals wegen eines Plattenepithelkarzinoms im oberen Aerodigestivtrakt behandelten Patienten ist die Tumorerkrankung fortgeschritten (UICC-Stadium III oder IV). Heute können etwa 50% der Patienten primär geheilt werden. Neuere Studien enthalten Hinweise, dass das Fernmetastasenrisiko nach Induktions-Chemotherapie (CT) geringer ist als nach primärer Radio-CT (RCT). Hyperfraktionierung oder akzelerierte Bestrahlung mit gleichzeitigem Boost sind der klassischen RT überlegen. Bei der intensitätsmodulierten RT (IMRT) ist die Dosisverteilung besser angepasst. Die Targettherapie (TT) mit Antikörpern, z. B. gegen den epidermalen Wachstumsfaktorrezeptor (EGFR) zeigte eine Überlegenheit gegenüber der alleinigen RT, gegenüber der klassischen RCT steht dies noch aus. Die TT gegen VEGF („vascular endothelial growth factor“) erzielt einen antiangiogenetischen Effekt im Tumor. Bei Irresektabilität oder Fernmetastasen wird eine palliative CT bzw. TT empfohlen. Die Wiederbestrahlung oder IMRT bietet bei hoher Toxizität eine erhöhte lokoregionäre Kontrolle. Insgesamt liegen durch die Erforschung der Tumorbiologie zunehmend prognostische Faktoren und Marker für eine individuelle TT und CT vor.

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Titel: Strahlen-, Chemo- und Targettherapie von Kopf-Hals-Karzinomen
Neue Entwicklungen
verfasst von: Prof. Dr. R. Knecht
Publikationsdatum: 01.05.2009
Verlag: Springer-Verlag
Erschienen in: HNO / Ausgabe 5/2009
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI: https://doi.org/10.1007/s00106-009-1909-0

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