Der Urologe

, Volume 56, Issue 3, pp 293–300 | Cite as

Pathogenese urologischer Komplikationen nach Strahlentherapie

Leitthema

Zusammenfassung

Die Strahlentherapie ist eine gängige, häufig eingesetzte uroonkologische Behandlungsmethode. Eine häufige Indikation zur Strahlentherapie im urologischen Bereich ist Behandlung des Prostatakarzinoms. Hier wird sie entweder als primär kurativer Ansatz, oder aber postoperativ als Adjuvans bzw. als sog. Salvagetherapie eingesetzt. In diesem Übersichtsartikel fassen wir die pathogenetischen Mechanismen der Strahlenschäden zusammen und stellen die typischen strahlenbedingten Gewebeveränderungen vor. Zwar können alle urogenitalen Organe Strahlenschäden erleiden, am häufigsten ist jedoch die Harnblase betroffen, welche eine typische Reaktionskaskade zeigt, die akute und späte Veränderungen in einer dosisabhängigen Weise einschließt. Eine Bestrahlung der Prostata zeigt Auswirkungen auf die Harnblase (oft) und seltener auf die Harnröhre (speziell die bulbomembranöse Harnröhre). Eine Harnleiterschädigung mit Strikturbildung ist fast immer eine Folge intraoperativer Radiatio bzw. externer Nachbestrahlung von außerurologischen Malignomen (gynäkologische Organe, Rektum, retroperitoneale Weichteiltumoren). Die postradiotherapeutischen Gewebeveränderungen insbesondere der Prostata können diagnostische Probleme für Urologen und Pathologen verursachen.

Schlüsselwörter

Bestrahlung Harnblase Prostata Strahlungsdosis Zellzyklus 

Pathogenesis of urological complications after radiation therapy

Abstract

Radiation therapy is a treatment modality that is often used in the uro-oncological setting. The common indication for the radiation therapy in the urological sphere is prostate cancer, whether it is used primarily as a radical approach, or postoperatively as adjuvant or salvage therapy. All urological organs are sensitive to radiation injury with the urinary bladder being the most susceptible with a typical cascade including acute and late changes, arising in the dose-dependent manner. The common indication for radiation therapy in urology is prostate cancer, which collaterally affects the urinary bladder and rarely urethra (especially the bulbo-membranous urethra). Ureteral damage and stricture formation is almost always restricted to the cases of intraoperative therapy and external beam radiation therapy for other urological malignancies (gynecological organs, rectum, retroperitoneal soft tissue tumors) and should not be underestimated. Postradiotherapeutic tissue changes, especially of the prostate, can cause difficulties for pathologists and urologists with regard to diagnosis of prostate cancer recurrence and salvage therapy.

Keywords

Radiation therapy Urinary bladder Prostate Radiation dosage Cell cycle 

Notes

Einhaltung ethischer Richtlinien

Interessenkonflikt

Y. Tolkach und G. Kristiansen geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Copyright information

© Springer Medizin Verlag Berlin 2016

Authors and Affiliations

  1. 1.Institut für PathologieUniversitätsklinikum BonnBonnDeutschland

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