Zusammenfassung
In den letzten Jahren stehen bei Patienten mit Lebertumoren interdisziplinäre Therapieansätze mit Betonung minimalinvasiver Verfahren zur Reduktion der Tumorlast zunehmend im Fokus. Lokal ablative Verfahren zur Behandlung des HCC und von Lebermetastasen kolorektaler Tumoren sind bereits in Behandlungsempfehlungen und Leitlinien integriert. Der folgende Beitrag stellt die häufigsten Verfahren vor und beschreibt ihre Relevanz für den klinischen Alltag.
Abstract
The past years have seen a paradigm shift in the treatment strategies of liver tumors. Due to increasing data interdisciplinary therapy regimens focusing on minimally invasive image guided interventions in combination with surgical procedures and chemotherapy are more and more employed. At present image guided local ablations are part of the international guidelines for the treatment of hepatocellular carcinoma and liver metastases of colon carcinoma with more indications to come in the near future.
Image guide local ablations of liver tumors offer various advantages such as a low peri- and post-interventional morbidity and mortality as well as a short hospital stay when compared to classic liver surgery. Owing to the fact that local ablations are confined to the malignant lesion itself and thus spare the residual liver parenchyma they can be repetitively used and easily combined with surgical resections and systemic chemotherapy. Nowadays a multitude of local ablation approaches exists but by far the most common utilized is radiofrequency ablation. When malignant liver lesions are extensive a high-dose brachytherapy is promising. The ablation procedure to be used is chosen by the interdisciplinary oncology team in charge taking into consideration both the individual patient situation as well as the local expertise.
Schlüsselwörter
Lebertumor - lokale Ablation - hepatozelluläres Karzinom - Kolonkarzinom - Radiofrequenzablation - Hochdosis-Brachytherapie
Key words
Image guided interventions - local ablation - liver tumor - hepatocellular carcinoma - colon carcinoma - radiofrequency ablation - high-dose brachytherapy
