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Antineoplastische Therapie

  • K.-H. Zurborn

Zusammenfassung

Die Effektivität der Chemotherapie eines Tumors ist abhängig von dessen Wachstumsfraktion, d.h. dem im aktiven Zellzyklus befindlichen Anteil der Tumorzellen. Dies gilt insbesondere für zellzyklus-phasenspezifische Zytostatika wie z. B. die Antimetaboliten, die nur in der S-Phase wirksam werden können und die Spindelgifte in der M-Phase. Für diese Zytostatika besteht also eine temporäre Resistenz für den Anteil Tumorzellen, die sich derzeit nicht in der empfindlichen Phase befinden, die jedoch zu einem anderen Zeitpunkt in diese Zyklusphase rekrutiert werden können. Bei einigen Tumoren mit hoher Wachstumsrate ist daher heute die systemische Chemotherapie in kurativer Absicht einsetzbar, wie bei malignen Lymphomen und Leukämien, aber auch bei einigen soliden Tumoren. Da in diesen Fällen eine anderweitige Heilungschance nicht besteht, können schwerwiegende akute oder auch Langzeitnebenwirkungen in Kauf genommen werden. Die palliative Therapie hingegen zielt lediglich auf eine Besserung der Symptome ohne Heilungsaussichten der Erkrankung ab. Stark nebenwirkungsreiche Therapieschemata sind daher hierbei nicht gerechtfertigt. Zytostatika können nicht selektiv auf Tumorzellen wirken, da keine grundsätzlichen biochemischen Unterschiede zwischen Tumorzellen und normalen Zellen bestehen. Es ist

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  • K.-H. Zurborn

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