Diagnostik und metastasengerichtete interdisziplinäre Therapie beim Prostatakarzinom

• Verfasst von: Ehmann, Michael [VerfasserIn]
• Verfasst von: Wenz, Frederik [VerfasserIn]
• Titel: Diagnostik und metastasengerichtete interdisziplinäre Therapie beim Prostatakarzinom
• Verf.angabe: M. Ehmann, S. Höcht, D. Böhmer, F. Wenz
• E-Jahr: 2019
• Jahr: [April 2019]
• Umfang: 5 S.
• Illustrationen: Illustrationen
• Fussnoten: First Online: 20 February 2019 ; Gesehen am 18.04.2019
• Titel Quelle: Enthalten in: Der Onkologe
• Ort Quelle: Berlin : Springer, 1996
• Jahr Quelle: 2019
• Band/Heft Quelle: 25(2019), 4, Seite 338-342
• ISSN Quelle: 1433-0415
• DOI: doi:10.1007/s00761-019-0531-3
• Datenträger: Online-Ressource
• Sprache: ger
• Sach-SW: Bestrahlung
• Sach-SW: Hypofractionation
• Sach-SW: Hypofraktionierung
• Sach-SW: Oligometastases
• Sach-SW: Oligometastasierung
• Sach-SW: PSMA-PET-CT
• Sach-SW: Radiotherapy
• Sach-SW: Stereotactic Body Radiotherapy
• K10plus-PPN: 1663449139

Abstract

BackgroundA paradigm shift in oligometastatic prostate cancer has begun and metastasization no longer necessarily means a classical palliative situation.ObjectivePresentation of the current diagnostic possibilities of oligometastatic prostate cancer in the context of metastases-directed interdisciplinary treatment and the therapeutic approach.Material and methodsReview of the current literature including meta-analyses as well as guidelines and expert recommendations.ResultsEssential for the accurate localization, detection and treatment of (oligo)metastases is the most sensitive and precise diagnostic imaging possible. In addition to well-established basic imaging diagnostics, this increasingly includes sectional imaging-based functional procedures, such as multiparametric magnetic resonance imaging (mMRI) and prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT). With respect to treatment, the irradiation of up to three metastases in oligometastatic patients can prolong the androgen deprivation-free time, progression-free survival and increase the quality of life. Bone and lymph node metastases can be treated with hypofractionated stereotactic irradiation regimens meaning only a few fractions with high single doses. Local control greater than 90% and clinically progression-free survival up to 71% at very low toxicity rates can be achieved with these regimens.ConclusionThe metastases-directed interdisciplinary treatment of oligometastatic prostate cancer leads to further personalization and adaptation of treatment concepts and softens the previous hard boundaries between “palliative” and “curative”. For this purpose, hypofractionated irradiation schemes as well as stereotactic body radiotherapy are increasingly being used.