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Stellenwert der systemischen Chemotherapie bei fortgeschrittener peritonealer Metastasierung

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Peritoneale Tumoren und Metastasen

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Zusammenfassung

Das Auftreten peritonealer Metastasierung (PM) solider Tumoren stellt eine interdisziplinäre Herausforderung dar und erfordert individuell angepasste Konzepte der Therapie. Sie ist in aller Regel mit einer Verschlechterung der Prognose sowie – von wenigen Ausnahmen abgesehen – dem Verlust kurativer Therapieoptionen vergesellschaftet. Grundsätzlich ist eine systemische Chemotherapie auch bei peritonealer Metastasierung wirksam. Allerdings scheint das Ansprechen signifikant schlechter als beispielsweise bei hepatischer Metastasierung zu sein. Dies erklärt man sich unter anderem mit einer schlechteren Durchblutung des Peritoneums und damit einhergehend auch der peritonealen Metastasen. Präklinische Untersuchungen unterstreichen die Bedeutung der Angioneogenese für die Entstehung und die Dissemination der PM. Vor diesem Hintergrund werden im Stadium IV beim kolorektalen Karzinom, aber auch beim Magen- und Ovarialkarzinom, regelhaft antiangiogenetische Substanzen eingesetzt. Eine der spezifischen Situation – peritoneale Metastasierung – angepasste Systemtherapie existiert derzeit allerdings nicht.

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Authors and Affiliations

  1. Universitätsklinik Leipzig, Universitäres Krebszentrum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland

    Dr. med. T. Golombek & Prof. Dr. med. F. Lordick

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  1. Dr. med. T. Golombek
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  2. Prof. Dr. med. F. Lordick
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Correspondence to T. Golombek or F. Lordick .

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Editors and Affiliations

  1. Charité Campus Virchow-Klinikum, Berlin, Deutschland

    Beate Rau

  2. Krankenhaus Barmherzige Brüder, Regensburg, Deutschland

    Pompiliu Piso

  3. Universitätsklinikum Tübingen, Tübingen, Deutschland

    Alfred Königsrainer

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Golombek, T., Lordick, F. (2018). Stellenwert der systemischen Chemotherapie bei fortgeschrittener peritonealer Metastasierung. In: Rau, B., Piso, P., Königsrainer, A. (eds) Peritoneale Tumoren und Metastasen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54500-3_26

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  • DOI: https://doi.org/10.1007/978-3-662-54500-3_26

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