Zusammenfassung
Fernmetastasen solider Tumoren sind — auch bei unilokulärer Manifestation — als Hinweis auf eine systemische Tumorerkrankung anzusehen und können mittels Operation oder Radiotherapie nur selten kurativ behandelt werden. In einzelnen Fällen, in denen die Metastasierung in nur einem Organ bzw. einer umschriebenen anatomischen Region auftritt, ist eine regionale Therapie zur erwägen. Das Konzept einer regionalen Tumorbehandlung wurde in den frühen 50iger Jahren von Kopp et al. [1 J und Bierman et al. [2] entwickelt, die Stickstoff-Lost intraarteriell in verschiedene Tumoren infundierten. Die arterielle Leberperfusion mittels Zytostatika wurde von Watkins und Sullivan [3, 4] entwickelt, die über einen Teflon-Katheter 5-Fluorouracil (5-FU) oder 2’-Deoxy-5-Fluorouridin (FUDR) mit Hilfe einer externen Infusionspumpe in die Arteria hepatica communis applizierten. Obwohl diese ersten Therapieversuche in zahlreichen Komplikationen resultierten, stellt die arterielle Leberinfusion (hepatic arterial infusion; HAI) aufgrund technischer Weiterentwicklungen heute für zahlreiche Patienten eine erwägenswerte Therapieoption dar. Die regionale Therapie hepatischer Metastasen mit Standard-Chemotherapeutika ist aus mehreren Gründen durchführbar: einer zweifachen Blutversorgung der Leber; einer hohen Gewebetoleranz gegenüber den meisten chemotherapeutischen Substanzen; geeigneter Pharmakokinetik der am häufigsten für die HAI-Therapie angewendeten Zytostatika.
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Jones, D.V., Hoque, A., Patt, Y.Z. (1998). Regionale Therapie hepatischer Tumoren. In: Seeber, S., Schütte, J. (eds) Therapiekonzepte Onkologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10493-4_30
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