Zusammenfassung
Einleitung: Die intraoperative Strahlentherapie wurde bereits in den 80er-Jahren vermehrt in multimodale Therapiekonzepte zur Verbesserung der lokalen Tumorkontrolle nach chirurgischer Resektion aufgenommen. Ziel dieser Arbeit war es, die aktuelle klinische und wissenschaftliche Aktivität auf dem Gebiet der intraoperativen Strahlentherapie in Deutschland zu ermitteln.
Methode: Fragebogen wurden an insgesamt 102 chirurgische und strahlentherapeutische Zentren in Deutschland versandt, um die derzeitige Aktivität der intraoperativen Strahlentherapie zu erfassen. Ferner wurde eine „Medline”-Literaturanalyse für den Zeitraum 1975 bis 2001 durchgeführt.
Ergebnisse: 92 % der angeschriebenen Zentren beantworteten den Fragebogen. IORT wird demnach in 24 Zentren (darunter befinden sich 16 Universitätskliniken) durchgeführt. Hauptindikationen liegen beim Rektumkarzinom und beim Weichteilsarkom. Des Weiteren wird die IORT im Bereich der Allgemeinchirurgie bei der Therapie von Magen-, Pankreas- und Gallengangskarzinomen eingesetzt. Einige Arbeitsgruppen bemühen sich aber auch um Kopf-Hals-Tumoren und hochmaligne Hirntumoren. Der jährliche Anteil deutscher Zentren an internationalen Publikationen zur IORT betrug in den letzten 5 Jahren im Mittel 14 %.
Schlussfolgerung: Es besteht eine beständige Aktivität auf dem Gebiet der IORT in Deutschland, die auf wenige Zentren konzentriert ist. Notwendig erscheint eine enge nationale und internationale Kooperation zwischen den IORT-Zentren, um in einem überschaubaren Zeitrahmen kontrollierte Studien durchführen zu können.
Abstract
Background: Intraoperative radiotherapy (IORT) represents an attractive method for local tumour control after surgical resection. IORT was introduced into multimodal treatment protocols in the 1980ies. Aim of this study was to analyse the actual clinical and scientific activity of IORT in Germany.
Methods: Questionnaires were sent to 102 centres in Germany. The analysis was focussed on indications in general surgery including bone tumours to evaluate the activity of IORT. The literature was analysed by a medline search for the years 1975 to 2001.
Results: Questionnaires were answered by 92 % of the centres. 24 departments are working with IORT in Germany (16 of them are university hospitals). Main Indications for IORT treatment are rectum carcinoma and soft tissue sarcoma. Furthermore, IORT is used in patients suffering from gastric, pancreatic and bile duct malignancies. Some IORT programs are also targeting on patients with head and neck malignancies and brain tumours. German institutions published within the last 5 years about 14 % of all “ Medline”-listed publications concerning IORT.
Conclusion: There is an profound activity of IORT in Germany, which is concentrated on a few centres. A need for better national and international cooperation of centres performing IORT for clinical trials and to collect significant numbers of patients seems to be evident.
Schlüsselwörter
IORT - Strahlentherapie - Chirurgie - Onkologie - Deutschland
Key words
IORT - radiotherapy - surgery - oncology - Germany
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Dr. G. M. Kaiser
Klinik für Allgemein- und Transplantationschirurgie Universitätsklinikum Essen · Gesamthochschule Essen
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