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Dtsch Med Wochenschr 2021; 146(22): 1478-1487
DOI: 10.1055/a-1391-5302
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Lokal fortgeschrittenes Rektumkarzinom

Standards und neue Konzepte multimodaler TherapienLocally advanced rectal cancerStandards and new multimodality treatment concepts
Ralf-Dieter Hofheinz
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Die Behandlungsstrategien beim lokal fortgeschrittenen Rektumkarzinom sind stark im Wandel. Die in den Leitlinien für lokal fortgeschrittene Tumoren empfohlene Therapie einer neoadjuvanten Radio(chemo)therapie gefolgt von Chirurgie und ggf. adjuvanter Therapie wird zunehmend zugunsten neuer Optionen und Studienkonzepte verlassen. Im vorliegenden Beitrag sollen diese ausgehend vom leitlinienbasierten Status quo diskutiert werden.

Abstract

Treatment strategies for locally advanced rectal cancer are changing dramatically. The treatment recommended in the guidelines for locally advanced tumors of neoadjuvant radio(chemo)therapy (RChT), followed by surgery and, if necessary, adjuvant therapy, are increasingly be abandoned in favor of the following concepts: (i) prolonged neoadjuvant (RChT (i. e. “more chemotherapy before resection”, referred to as total neoadjuvant therapy, TNT); (ii) omission of radiotherapy in tumors with a low risk of local recurrence; (iii) organ preservation in patients with a complete clinical response after neoadjuvant radiochemotherapy. Herein, current strategies and study concepts are to be discussed based on the guideline-based status quo.

Schlüsselwörter

Rektumkarzinom - perioperative Therapie - totale neoadjuvante Therapie - Oxaliplatin

Key words

rectal cancer - perioperative treatment - total neoadjuvant therapy - oxaliplatin


Publication History

Article published online:
05 November 2021

© 2021. Thieme. All rights reserved.

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