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Behandlung maligner Tumoren der Pleura

Kombination von chirurgischer Zytoreduktion und hyperthermer intrathorakaler Chemotherapieperfusion

Treatment of malignant pleural tumors

Combination of cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion

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Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Derzeit existieren noch keine Behandlungsstandards zur effektiven Therapie primär maligner (Pleuramesotheliom) und sekundär maligner Pleuratumoren (z. B. metastasierte Thymome). Bisher konnte eine Verbesserung des Gesamtüberlebens lediglich durch trimodale Behandlungen bestehend aus Operation, Chemotherapie und Radiotherapie erreicht werden. Das lokale Tumorrezidiv im Thorax limitiert jedoch sowohl das Langzeitüberleben als auch die Lebensqualität der betroffenen Patienten. Zur verbesserten Tumorkontrolle wird derzeit eine Kombination aus chirurgischer Zytoreduktion und hyperthermer intrathorakaler Chemotherapieperfusion zur effektiveren Behandlung primärer und sekundärer maligner Tumoren der Pleura evaluiert. Erste klinische Ergebnisse zeigen, dass durch diese Kombinationstherapie als zusätzliche Therapieoption im Rahmen von multimodalen Behandlungsregimen Verbesserungen hinsichtlich lokaler Tumorkontrolle und Lebensqualität möglich sind. In diesem Übersichtsartikel werden die Grundlagen dieses additiven Therapiekonzepts vorgestellt und die internationale Literatur diskutiert. Daneben wird ein kurzer Ausblick über noch notwendige Forschungsprojekte gegeben.

Abstract

There is currently no standard regime for the effective treatment of malignant pleural mesothelioma and advanced thymoma with pleural involvement. However, improvement in overall survival was achieved by using multimodality therapy including surgical resection, chemotherapy, and radiotherapy. Local tumor recurrence results in poor long-term outcome and quality of life of these patients. More recently, the combination of cytoreductive surgery and hyperthermic intrathoracic chemotherapy perfusion was evaluated for the treatment of primary and secondary pleural malignancies. This combination technique might improve local tumor control and, therefore, prognosis of patients with pleural tumors in a multimodal treatment setting. Recent results are promising and may encourage the use of this innovative therapy as an additional tool. In this report, relevant literature is reviewed and a short overview of essential, future research projects is provided.

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  1. Abteilung für Thoraxchirurgie, Klinik und Poliklinik für Herz-, Thorax- und herznahe Gefäßchirurgie, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    M. Ried, T. Potzger, N. Braune, R. Neu & H.-S. Hofmann

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  1. M. Ried
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  2. T. Potzger
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  4. R. Neu
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  5. H.-S. Hofmann
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Correspondence to M. Ried.

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Ried, M., Potzger, T., Braune, N. et al. Behandlung maligner Tumoren der Pleura. Z Herz- Thorax- Gefäßchir 26, 259–262 (2012). https://doi.org/10.1007/s00398-012-0931-9

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  • DOI: https://doi.org/10.1007/s00398-012-0931-9

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