Skip to main content

Prinzipien der chirurgischen Onkologie

  • Chapter
Book cover Therapie gastrointestinaler Tumoren

Zusammenfassung

In der modernen Onkologie kommt es immer mehr zu einer Verflechtung von Chirurgie, Chemotherapie und Strahlentherapie auf dem Boden multimodaler Strategien. Der Grund dafür ist, daß trotz kompletter Tumorresektion (R0) die Langzeitergebnisse für Patienten mit lokal fortgeschrittenen Tumoren des Gastrointestinaltraktes bis heute unbefriedigend sind. Im Rahmen der multimodalen Therapie wird die Chemotherapie, die Strahlentherapie und die Radio-/Chemotherapie eingesetzt. Dies ist möglich vor, während und nach einer Resektion. Im folgenden werden die klinischen und theoretischen Grundlagen dieser kombinierten Therapieprinzipien dargestellt.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 44.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 59.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Weiterführende Literatur

  • Fink U, Stein HJ, Siewert, JR (1998) Multimodale Therapie bei Tumoren des oberen Gastrointestinal-trakts. Chirurg 69: 349–359

    Article  PubMed  CAS  Google Scholar 

  • Fink U, Stein HJ, Schuhmacher C, Wilke HJ (1995) Neoadjuvant therapy for gastric cancer: Update. World J Surg 19: 509–516

    Article  PubMed  CAS  Google Scholar 

  • Fisher B, Gunduz N, Saffer EA (1983) Influence on the interval between primary tumor removal and chemotherapy on kinetics and growth of metastases. Cancer res 43: 1488–1492

    PubMed  CAS  Google Scholar 

  • Gunduz N, Fisher B, Saffer EA (1979) Effect on surgical removal on the growth and kinetics of residual tumor. Cancer res 39: 1361–1365

    Google Scholar 

  • Hamada M, Fujiwara T, Hizuta A, Gochi A, Naomoto Y, Takakura N, Takahashi K, Roth JA, Tanaka N, Orita K (1996) The p53 gene is a potent determinant of chemosensivity and radiosensivity in gastric and colorectal cancers. J Cancer Res Clin Oncol 122: 360–365

    Article  PubMed  CAS  Google Scholar 

  • Hermans J, Bonenkamp JJ, Boon MC, Bunt AM, Ohyama S, Sasako M, van de Velde CJ (1993) Adjuvant therapy after curative resection for gastric cancer: meta analysis of randomized trials. J Clin Oncol 11:1441–1447

    PubMed  CAS  Google Scholar 

  • Johnston PG, Lenz HJ, Leichman CG, Dannenberg KD, Allegra CJ, Dannenberg PV, Leichman L (1995) Thymidilate Synthase Gene and protein expression correlate and are associated with response to 5-fluouracil in human colorectal and gastric tumors. Cancer Res 55: 1407–1412

    PubMed  CAS  Google Scholar 

  • McNamara DA, Harmey JH, Walsh TN, Redmond HP, Bouchier-Hayes DJ (1998) Significance of angiogenesis in cancer therapy British J Surg 85: 1044–1055

    Article  CAS  Google Scholar 

  • Murphy SM, Goldschmidt RA, Rao LN (1989) The influence of surgical trauma on experimental metastasis. Cancer 64: 2035–2044

    Article  Google Scholar 

  • Siewert JR, Sendler A, Dittler HJ, Fink U, Höfler H (1995) Staging of gastrointestinal cancer as a precondition for multimodal treatment. World J Surg 19: 168–177

    Article  PubMed  CAS  Google Scholar 

  • Allen-Mersch TG, Earlam S, Fordy C, Abrams K, Houghton T (1994) Quality of life and survival with continous hepatic-artery floxurdine infusion for colorectal liver metastases. Lancet 344: 1255–1260

    Article  Google Scholar 

  • Asahara T, Kikkawa M, Okajiama M, Ojima Y, Toyota K, Nakahara H, Katayama K, Itamoto T, Marubayashi S, One E, Yahata H, Dohi K, Azuma K, Ito K (1998) Studies of postoperative transarterial infusion chemotherapy for liver metastasis of colorectal carcinoma after hepatectomy. Hepato-Gastroenterology 45: 805–11

    PubMed  CAS  Google Scholar 

  • Berger H, Baethge I, Rudolphi A, Boos KS, Stäbler A, Reiser M, Seidel D (1998) Transcatheter chemoem-bolisation of hepatocellular carcinoma: a study of the pharmacokinetics of epirubicin with lipiodol or starch microspheres as embolizing agent. Reg Cancer Treatment 9: 181–185

    Google Scholar 

  • Bronowicki JP, Vetter D, Dumas F, Boudjema K, Bader R, Weiss AM, Wenger JJ, Boisel P, Bigard MA, Doffoel M (1994) Transcatheter oily chemoembolization for hepatocellular carcinoma. Cancer 74:16–24

    Article  PubMed  CAS  Google Scholar 

  • Gansauge F, Link KH, Rillinger N, Kunz R, Berger HG (1996) Adjuvante regionale Chemotherapie beim resezierten fortgeschrittenen Pankreaskarzinom. Chirurg 67: 362–365

    PubMed  CAS  Google Scholar 

  • Goldberg SN, Solbiati L, Hahn R F, Cosman E, Conrad JE, Fogle R, Gazelle GS (1998) Large-volume tissue ablation with radio-frequency by using a clustered, internally cooled electrode technique: Laboratory and clinical experience in liver metastases. Radiology 209: 371–379

    PubMed  CAS  Google Scholar 

  • Group d’étude et de traitment du carcinom hépatocellulaire (1995) A comparison of lipiodol chemoembolization and conservative traetment for unresectable hepatocellular carcinoma. N Engl J Med 332: 1256–1261

    Article  Google Scholar 

  • Livraghi T, Giorgio A, Marin G, Solmi A, de Sio I, Bolondi L, Pompili M, Brunello F, Lazzaroni S, Torzilli G, Zucchi A (1995) Hepatocellular carcinoma and cirrhosis in 746 patients: Long term results of percutaneous ethanol injection. Radioloy 197: 101–108

    CAS  Google Scholar 

  • Meta-Analysis Group in Cancer (1996) Reappraisal of hepatic arterial infusion in the treatment of non-resectable liver metastases from colorectal cancer. J Natl Cancer Inst 88,5: 252–258

    Article  Google Scholar 

  • Muchmore JH, Preslau JE, George WJ (1996) Regional chemotherapy for inoperable pancreatic carcinoma. Cancer 78: 664–673

    PubMed  CAS  Google Scholar 

  • Vogl T, Mack MG, Roggau A, Straub R, Eichler KC, Müller PK, Knappe V, Felix R (1998) Internally cooled power laser for MR-guided interstitial laser-induced thermotherapy of liver lesions: initial clinical results. Radiology 209: 381–385

    PubMed  CAS  Google Scholar 

  • Calvo FA, Santos M, Brady LW (Eds) (1992) Intraoperative Radiotherapy, Clinical Experiences and Results, Springer, Berlin

    Google Scholar 

  • Feldmann HJ, Zimmermann FB, Stepan R, Nekarda H, Kneschaurek P, Molls M (1998) Locally advanced rectal cancer: intraoperative radiotherapy using the flab method combined with pre- and postoperative radiochemotherapy. In: Kogelnik HD, Sedlmayer F (Eds) Progress in Radio-Oncology VI Mon-duzzi Editore S.p.A., Bologna/Italy, S 417–422

    Google Scholar 

  • Grosu L, Stärk S, Feldmann HJ, Kneschaurek P, Leonardi M, Lumenta Ch, Molls M (1998) Stereotaktische Konvergenzbestrahlung am Linearbeschleuniger: Bildgebung, Technik und klinische Indikationen. Röntgenpraxis 51:9–15

    PubMed  CAS  Google Scholar 

  • Huber FT, Stepan R, Zimmermann F, Fink U, Molls M, Siewert JR (1996) Locally advanced rectal cancer: resection and intraoperative radiotherapy using the flab method combined with preoperative or postoperative radiochemotherapy. Dis Col Rect 39: 774–779

    Article  CAS  Google Scholar 

  • Kneschaurek P, Wehrmann R, Hugo Ch, Stepan R, Lukas P, Molls M (1995) Die Flab-Methode zur intraoperativen Bestrahlung. Strahlenther Onkol 171: 61–70

    PubMed  CAS  Google Scholar 

  • Molls M, Vaupel P (Eds) (1998) Blood Perfusion and Microenvironment of Human Tumors. Implications for Clinical Radiooncology. Springer, Berlin

    Google Scholar 

  • Molls M (1998) Prinzipien der Kombination von Radiotherapie und Chemotherapie. In: Scherer E, Sack H (Hrsg.) Strahlentherapie, Radiologische Onkologie. 4. Aufl. Springer S 189–205

    Google Scholar 

  • Pahlman L, Glimelius B (Swedish Cancer Trial) (1997) Improved survival with preoperative radiotherapy in resectable rectal cancer. N Eng J Med 336: 980–987

    Article  Google Scholar 

  • Scherer E, Sack H (Hrsg) (1996) Strahlentherapie, Radiologische Onkologie, Springer, Berlin

    Google Scholar 

  • Streffer C, Müller WU (1984) Radiation risk from combined exposures to ionizing radiations and chemicals. Adv Radiat Biol 11: 173–210

    CAS  Google Scholar 

  • Tannock F (1992) Potential for therapeutic gain from combined-modality treatment. In: Meyer JL, Vaeth JM (Eds) Radiotherapy/Chemotherapy Interactions in Cancer Treatment. Front Radiat Ther Oncol 26, Karger, Basel p 1–15

    Google Scholar 

  • Withers HR, McBride WH (1997) Biologic Basis of Radiation Therapy. In: Perez CA, Brady LW (Eds) Principles and Practice of Radiation Oncology. Lippincott-Raven, Philadelphia 79: 118

    Google Scholar 

  • Zimmermann FB, Molls M (1998) Three-dimensional treatment planning: principles and practice. Onkologie 21: 474–484

    Article  Google Scholar 

  • Baumgartner I, Pieczk A, Manor 0, Blair R, Kearney M, Walsh K, Isner JM (1998) Constitutive expression of phVEGF 165 after intramuscular gene transfer promotes collateral vessel development in patients with critical limb ischemia. Circulation 97: 1114–1123

    PubMed  CAS  Google Scholar 

  • Cristiano RJ, Xu B, Nguyen D, Schumacher G, Kataoka M, Spitz FR, Roth JA (1998) Viral and nonviral delivery vectors for cancer gene therapy. Cancer Detect Prev 22: 445–454

    Article  PubMed  CAS  Google Scholar 

  • Dranoff G (1998) Cancer gene therapy: Connecting basic science with clinical inquiry. J Clin Oncol 16: 2548–2556

    PubMed  CAS  Google Scholar 

  • Hantzopoulos P, Gänsbacher B (1996) Gentherapie: Stand und Ausblick. Chirurg 67: 980–983

    Article  PubMed  CAS  Google Scholar 

  • Hodi F, Dranoff G (1998) Genetically modified tumor cell vaccines. Surg Oncol Clin N Am 7: 471–485

    PubMed  CAS  Google Scholar 

  • Lashford L (1997) Possibilities of gene therapies for cancer. Ann Med 29: 1–4

    Article  PubMed  CAS  Google Scholar 

  • Losordo DW, Vale PR, Symes JF, Dunnington ChH, Esakof DD, Maysky M, Ashare AB, Lathi K, Isner JM (1998) Gene therapy for myocardial angiogenesis. Initial clinical results with direct myocardial injection of phVEGF165 as sole therapy for myocardial ischemia. Circulation 98: 2800–2804

    PubMed  CAS  Google Scholar 

  • Medin J, Karlsson S (1997) Viral vectors for gene therapy of haematopoetic cells. Immunotechnology 3: 19

    Article  Google Scholar 

  • Naldini L (1998) Lentiviruses as gene transfer agents for delivery to non-dividing cells. Curr Opin Biotechnol 9: 480–485

    Article  Google Scholar 

  • Robbins PD, Ghivizzani SC (1998) Viral vectors for gene therapy. Pharmacol Ther 80: 35–47

    Article  PubMed  CAS  Google Scholar 

  • Rosenfild M, Curiel D (1996) Gene therapy strategies for novel cancer therapeutics. Curr Opin Oncol 8: 72–77

    Article  Google Scholar 

  • Roth JA, Cristiano RJ (1997) Gene therapy for cancer: What have we done and where are we going? J Natl Cancer Inst 89: 21–39

    Article  PubMed  CAS  Google Scholar 

  • Springer ML, Chen AS, Kraft PE, Bednarski M, Blau HM (1998) VEGF gene delivery to muscle; Potential role for vasculogenesis in adults. Molecular Cell 2: 549–558

    Article  PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2000 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Fink, U. et al. (2000). Prinzipien der chirurgischen Onkologie. In: Roder, J.D., Stein, H.J., Fink, U. (eds) Therapie gastrointestinaler Tumoren. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59659-9_9

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-59659-9_9

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-64072-8

  • Online ISBN: 978-3-642-59659-9

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics