Zusammenfassung
Nach den aktuellen Publikationen im New England Journal of Medicine (TAX323, TAX324) der Studiengruppen um Jan Vermorken und Marschall Posner scheint die Induktionschemotherapie bei Plattenepithelkarzinomen des Kopf-Hals-Bereichs (im Näheren: Oro-Hypopharynx, Mundhöhle und Larynx) derzeit weltweit eine Renaissance zu erfahren. Renaissance deshalb, weil in den letzten Jahrzehnten das Thema in dieser Gruppe von Tumoren nach ausbleibender Überlebensverbesserung in der überwiegenden Mehrzahl von Studien wieder verlassen worden war. Es stellt sich die Frage, welche Entitäten von der Induktion, derzeit als Kombination von Docetaxel, Cisplatin und 5-Fluorouracil (TPF) empfohlen, profitieren? Dem ungebrochen hohen Stellenwert der Chirurgie mit ergänzender Bestrahlung bzw. Radiochemotherapie stand bislang die primäre Radiochemotherapie bei nicht resektablen Tumoren gegenüber. Derzeitige Studienaktivitäten versuchen, die Rolle der Induktionschemotherapie im aktuellen multimodalen Kontext zu klären.
Abstract
According to recent publications in the New England Journal of Medicine (TAX323, TAX324) of the study groups around Jan Vermorken and Marshall Posner induction chemotherapy in squamous cell carcinomas of the head-neck area (in the closer: Oro-hypopharynx, oral cavity and larynx) currently seems to generate a worldwide renaissance. Renaissance, because in the last few decades, induction chemo therapy in this group of tumors after lack of survival improvement in the vast majority of studies was again abandoned. The new data raise the question for which entities induction chemo therapy can be recommended (actually, a combination of docetaxel, cisplatin and 5-fluorouracil; TPF)? The unbroken high value of primary surgery with adjuvant radiation or chemo radiation was complementary to primary radio chemotherapy for non resectable tumors until today worldwide. Running studies are sorting out the role of induction chemotherapy in the current context of clarifying optimal multimodal treatment.
Schlüsselwörter
Induktionschemotherapie - Kopf-Hals-Tumore - Kehlkopf-Organerhalt - Chemoselektion
Key words
induction chemotherapy - chemo selection - head and neck tumor - organ preservation
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Univ.-Professor Dr. med. Andreas Dietz
Klinik und Poliklinik für Hals- Nasen- Ohrenheilkunde/Plastische Operationen
Universität Leipzig
Liebigstraße 10 - 14
04103 Leipzig
Email: andreas.dietz@medizin.uni-leipzig.de
URL: http://www.uni-leipzig.de/∼hno/
