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Strahlentherapie des Harnblasenkarzinoms

  • Chapter
Therapie des Harnblasenkarzinoms

Zusammenfassung

Mit der Einführung der Megavolttherapie wurde die Indikation einer Bestrahlung von Harnblasenkarzinomen teilweise unabhängig von der Größe der Tumorinvasion gestellt. Die nicht immer günstigen Ergebnisse, aber auch die inzwischen durch das TNM-System und das Grading sehr differenzierte Einteilung der urothelialen Tumoren hat dazu geführt, daß praktisch nur noch bei etwa einem Viertel der Patienten die Indikation einer Bestrahlung diskutiert wird. Tabelle 1 zeigt die Häufigkeit der verschiedenen Blasentumoren in Abhängigkeit von der T-Kategorie und vom Malignitätsgrad. So wird bei den häufigsten Tumoren der Klassifikation Ta Gl die Behandlung mit der transurethralen Resektion abgeschlossen sein. Die Tabelle zeigt weiter, daß fortgeschrittene Tumoren und auch Tumoren mit einem ungünstigen Grading seltener vorkommen. Hier ist die Indikation der Bestrahlung gegeben. Während bisher die Indikation der Bestrahlung als prä- oder postoperative bzw. alleinige Maßnahme diskutiert wurde, ist in den letzten Jahren mit Erfolg versucht worden, durch zytostatische Substanzen, wie Cisplatin, Adriamycin oder 5-Fluorouracil die Wirkung der Bestrahlung zu verstärken. Aufgrund der bisher vorliegenden Daten können möglicherweise durch die zuletzt genannten kombinierten Verfahren bessere Ergebnisse erzielt werden, so daß die Indikation einer Bestrahlung an Bedeutung gewinnen wird. Ein entscheidender Gesichtspunkt ist in diesem Zusammenhang, daß durch solche Behandlungskonzepte bei einem Teil der Patienten die Harnblase mit ausreichender Funktion erhalten bleibt.

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  1. Abteilung Strahlentherapie der Medizinischen Fakultät der RWTH Aachen, Pauwelsstraße, D-5100, Aachen, Germany

    J. Ammon, H.-B. Gehl & J. H. Karstens

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  2. H.-B. Gehl
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  1. Abteilung für Urologie der, Eberhard-Karls-Universität Tübingen, Calwer Straße 7, D-7400, Tübingen, Germany

    Karl-Horst Bichler , Stephan Heribert Flüchter  & Walter Ludwig Strohmaier ,  & 

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Ammon, J., Gehl, HB., Karstens, J.H. (1988). Strahlentherapie des Harnblasenkarzinoms. In: Bichler, KH., Flüchter, S.H., Strohmaier, W.L. (eds) Therapie des Harnblasenkarzinoms. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-72670-5_4

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