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Zentralbl Chir 2003; 128(11): 906-910
DOI: 10.1055/s-2003-44797
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© Georg Thieme Verlag Stuttgart · New York

Medikamentöse Therapie des hepatozellulären Karzinoms

Systemic Treatment for Hepatocellular CarcinomaH. C. Spangenberg1 , I. Zuber-Jerger1 , R. Thimme1 , H. E. Blum1 , F. von Weizsäcker1
  • 1Abteilung Innere Medizin II, Medizinische Universitätsklinik Albert-Ludwigs-Universität Freiburg(Ärztlicher Direktor: Prof. Dr. Drs. h. c. H. E. Blum)
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Publikationsverlauf

Publikationsdatum:
11. Dezember 2003 (online)

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Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist einer der häufigsten malignen Tumoren weltweit. Für die medikamentöse Therapie des HCC wurden bzw. werden verschiedene Strategien evaluiert: konventionelle Chemotherapie, Tamoxifen, Octreotid, Thymostimulin bzw. α1-Thymophysin, Pravastatin, 131J-Lipiodol sowie die transarterielle Chemoperfusion (TAC) bzw. Chemoembolisation (TACE). Lediglich für die TACE (als Monotherapie oder kombiniert mit Pravastatin) ließ sich bisher ein Überlebensvorteil bei selektionierten Patienten nachweisen. Neue, viel versprechende Therapiestrategien wie Immun- bzw. Gentherapie, Antiangiogenese und Cyclooxygenaseinhibition werden zur Zeit in präklinischen und klinischen Studien evaluiert. Für die Primärprävention des HCC existieren wirksame Strategien und auch in der Sekundärprävention sind erste Erfolge berichtet worden.

Abstract

Hepatocellular carcinoma (HCC) is one of the most frequent malignancies worldwide. A variety of pharmacological strategies has been evaluated in the treatment of HCC: classical chemotherapy, tamoxifen, octreotide, thymostimulin, pravastatin, 131I-lipiodol as well as transarterial chemoperfusion (TAC) and chemoembolisation (TACE). TACE monotherapy or TACE combined with pravastatin resulted in a survival benefit of selected HCC patients. New strategies such as immunotherapy, antiangiogenic agents or cyclooxygenase inhibitors are under clinical investigation and might play a role in future therapies for HCC. Efficient strategies for the primary prevention of HCC are available and promising concepts in the secondary prevention have been reported.

Schlüsselwörter

Hepatozelluläres Karzinom - medikamentöse Therapie - transarterielle Chemoembolisation - Antihormontherapie

Key words

Hepatocellular carcinoma - systemic therapy - transarterial chemoembolisation - tamoxifen - octreotide

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Prof. Dr. F. von Weizsäcker

Abteilung Innere Medizin II

Medizinische Universitätsklinik

Albert-Ludwigs-Universität Freiburg

Hugstetter Straße 55

79106 Freiburg

eMail: weiz@ukl.uni-freiburg.de