Minimal-invasive Krebstherapien

Zusammenfassung

Minimal-invasive Eingriffe erweitern wesentlich das therapeutische Spektrum in der Onkologie und eröffnen neue Dimensionen, was die Überlebensraten, aber auch die Therapieverträglichkeit und Patientenfreundlichkeit betrifft. Viele interdisziplinäre Behandlungskonzepte haben sich unter dem Einfluss minimal-invasiver Verfahren entscheidend verändert, und dieser Prozess ist noch nicht abgeschlossen. Die rasante Entwicklung minimal-invasiver Therapien lässt kurz-, mittel- und langfristig auf neue Therapiekonzepte hoffen. Bildgesteuerte Hybrid-Technologien ergänzen zunehmend und ersetzen teilweise klassische Operationen. Im neu angebrochenen Zeitalter der Immuno-Onkologie ist die interdisziplinäre Zusammenarbeit und die Konzentration auf individualisierte und patientennahe Therapien essentiell. Man kann Patienten wie Therapeuten nur ermutigen, mehr die radiologisch-interventionelle Expertise bezüglich minimal-invasiver Therapien zu nutzen.

Abstract

Minimal-invasive interventions considerably extend the therapeutic spectrum in oncology and open new dimensions in terms of survival, tolerability and patient-friendliness. Through the influence of image-guided interventions, many interdisciplinary therapy concepts have significantly evolved, and this process is by far not yet over. The rapid progression of minimal-invasive technologies offers hope for new therapeutic concepts in the short, medium and long term. Image-guided hybrid-technologies complement and even replace in selected cases classic surgery. In this newly begun era of immune-oncology, interdisciplinary collaboration and the focus on individualized and patient-friendly therapies are crucial. I can only encourage patients and therapists to make more use of the interventional-radiologic expertise in minimal-invasive therapies.

Schlüsselwörter

Interventionelle Onkologie - Krebsimmuntherapie - abscopaler Effekt - Checkpoint-Inhibitor

Key words

Interventional oncology - cancer immunotherapy - abscopal effect - checkpoint inhibitor

• Literatur

• 1 Ruers T, Van Coevorden F, Punt CJ. et al. European Organisation for Research and Treatment of Cancer (EORTC); Gastro-Intestinal Tract Cancer Group; Arbeitsgruppe Lebermetastasen und tumoren in der Chirurgischen Arbeitsgemeinschaft Onkologie (ALM-CAO); National Cancer Research Institute Colorectal Clinical Study Group (NCRI CCSG). Local treatment of unresectable colorectal liver metastases: results of a randomized phase II trial. J Natl Cancer Inst 2017; 109 (9). DOI: 10.1093/jnci/djx015.
• 2 Slovak R, Ludwig JM, Gettinger SN. et al. Immuno-thermal ablations – boosting the anticancer immune response. J Immunother Cancer 2017; 5: 78
• 3 Yin X, Cui L, Li F. et al. Radiofrequency ablation versus partial nephrectomy in treating small renal tumors: a systematic review and meta-analysis. Medicine (Baltimore) 2015; 94: e2255
• 4 Gillams A, Goldberg N, Ahmed M. et al. Thermal ablation of colorectal liver metastases: a position paper by an international panel of ablation experts, The Interventional Oncology Sans Frontières meeting 2013. Eur Radiol 2015; 25: 3438-3454
• 5 Fiorentini G, Aliberti C, Tilli M. et al. Intra-arterial infusion of irinotecan-loaded drug-eluting beads (DEBIRI) versus intravenous therapy (FOLFIRI) for hepatic metastases from colorectal cancer: final results of a phase III study. Anticancer Res 2012; 32: 1387-1395 Erratum in: Anticancer Res 2013; 33: 5211
• 6 Van Cutsem E, Cervantes A, Adam R. et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol 2016; 27: 1386-1422
• 7 Bertino G, Sersa G, De Terlizzi F. et al. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project: Results of the treatment of skin cancer. Eur J Cancer 2016; 63: 41-52
• 8 Edhemovic I, Brecelj E, Gasljevic G. et al. Intraoperative electrochemotherapy of colorectal liver metastases. J Surg Oncol 2014; 110: 320-327
• 9 Takahashi Y, Matsutani N, Nakayama T. et al. Immunological effect of local ablation combined with immunotherapy on solid malignancies. Chin J Cancer 2017; 36: 49
• 10 Abdo J, Cornell DL, Mittal SK, Agrawal DK. Immunotherapy plus cryotherapy: potential augmented abscopal effect for advanced cancers. Front Oncol 2018; 8: 85
• 11 Park SY, Kim JH, Yoon HJ. et al. Transarterial chemoembolization versus supportive therapy in the palliative treatment of unresectable intrahepatic cholangiocarcinoma. Clin Radiol 2011; 66: 322-328
• 12 Kim JH, Won HJ, Shin YM. et al. Radiofrequency ablation for the treatment of primary intrahepatic cholangiocarcinoma. AJR Am J Roentgenol 2011; 196: W205-W209
• 13 Prasad V. Do cancer drugs improve survival or quality of life?. BMJ 2017; 359: j4528
• 14 de Baère T, Aupérin A, Deschamps F. et al. Radiofrequency ablation is a valid treatment option for lung metastases: experience in 566 patients with 1037 metastases. Ann Oncol 2015; 26: 987-991
• 15 de Baere T, Tselikas L, Woodrum D. et al. Evaluating cryoablation of metastatic lung tumors in patients – safety and efficacy: The ECLIPSE Trial–interim analysis at 1 year. J Thorac Oncol 2015; 10: 1468-1474
• 16 de Baere T, Tselikas L, Pearson E. et al. Interventional oncology for liver and lung metastases from colorectal cancer: The current state of the art. Diagn Interv Imaging 2015; 96: 647-654
• 17 Huppert P, Wenzel T, Wietholtz H. Transcatheter arterial chemoembolization (TACE) of colorectal cancer liver metastases by irinotecan-eluting microspheres in a salvage patient population. Cardiovasc Intervent Radiol 2014; 37: 154-164