Strahlentherapie des Harnblasenkarzinoms

  • J. Ammon
  • H.-B. Gehl
  • J. H. Karstens

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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Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • J. Ammon
    • 1
  • H.-B. Gehl
    • 1
  • J. H. Karstens
    • 1
  1. 1.Abteilung Strahlentherapie der Medizinischen Fakultät der RWTH AachenAachenGermany

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