Zusammenfassung
In den letzten 10 Jahren verbesserten sich die tele- und die brachytherapeutische Strahlentherapie durch die Entwicklung und Implementierung neuer moderner Bestrahlungsgeräte, 3D-Bestrahlungsplanungsprogramme, moderner Fixationsmethoden, die Integration moderner bildgebender Verfahren [Mehrzeilen-CT (CT: Computertomographie), MRT (Magnetresonanztomographie)] sowie funktioneller Bildgebung [PET-CT (PET: Positronenemissionstomographie)] in den Planungsprozess deutlich. Die Definition des Tumorzielvolumens und der Risikoorgane können dadurch exakter durchgeführt und eine patientenspezifische Gestaltung der Dosisverteilung mit selektiver Schonung von Risikoorganen erstellt werden. Ziel einer modernen Strahlentherapie ist, die lokale Tumorkontrolle zu erhalten oder zu verbessern und dabei die Nebenwirkungsrate zu senken. Die Art der Bestrahlung sowie die hierfür notwendigen Energien werden individuell festgelegt. 90% der teletherapeutischen Bestrahlungen werden mit hochenergetischen Röntgen- bzw. Photonenstrahlen durchgeführt. Daneben werden in jüngster Zeit auch Protonen und Schwerionen verwendet. Aktuell wird geprüft, ob sich mit den neuen Methoden Verbesserungen der Behandlungsergebnisse erzielen lassen.
Abstract
Over the last decade, external beam therapy and brachytherapy have significantly improved due to the development and the implementation of modern treatment devices, 3-D conformal treatment planning software, rigid immobilization, modern multiple slice computed imaging modalities (computed tomography, magnetic resonance imaging) and functional imaging (positron emission tomography) in the planning process. The definition of target volumes and organs at risk has become more precise and individual configuration of dose plans as selective sparing of organs at risk has been achieved. The primary aim of modern radiation oncology is to preserve or even improve local tumor control while reducing the risk for treatment side-effects. The treatment modality and energy are individually chosen for each patient. More than 90% of patients are treated with high energy x-rays or photons. Recently, proton and heavy ion beam therapy have been introduced, however, clinical superiority has still to be proven.
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Dieckmann, K., Timmermann, B. Innovative Techniken und Partikeltherapie . Onkologe 17, 1005–1012 (2011). https://doi.org/10.1007/s00761-011-2161-2
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DOI: https://doi.org/10.1007/s00761-011-2161-2