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Multimodale Therapie des Ösophaguskarzinoms

Combined modality treatment of oesophageal cancer

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Zusammenfassung

Das Ösophaguskarzinom stellt eine Erkrankung dar, die als Prototyp für eine multimodale Therapie gelten kann. Die frühe lymphogene Metastasierung und späte Symptomatik führen dazu, dass die Tumoren regelhaft erst entdeckt werden, wenn sie mit einer alleinigen Operation nicht mehr kurativ behandelt werden können. Andererseits weisen die Karzinome eine hohe Empfindlichkeit gegenüber einer Chemo- und Strahlentherapie auf. Die Kombination aus Chemoradiotherapie und nachfolgender Operation, die trimodale Therapie, ist heute ein international akzeptierter Behandlungsstandard für geeignete Patienten. Die definitive Chemoradiotherapie oder das flexible Konzept der Chemoradiotherapie mit Salvage-Operation bei Bedarf sind kurative Optionen für Patienten mit erhöhtem Operationsrisiko.

Abstract

Oesophageal carcinoma reflects a tumor entity which can be optimally treated with multimodal therapy. Early lymphatic spread and late symptoms lead to mostly advanced tumors at primary diagnosis, which means that they can not be cured by surgery alone. On the other hand these tumors show high sensitivity towards chemo- and radiotherapy. Chemoradiotherapy followed by surgery (trimodal therapy) is considered an international standard of care for operable patients. Definitive chemoradiotherapy or the flexible concept of chemoradiotherapy with optional salvage surgery can be curative options for patients with increased operative risk.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Stahl und T. Ruhstaller geben an, dass kein Interessenkonflikt besteht. Alle im vorliegenden Manuskript beschriebenen Untersuchungen am Menschen wurden mit Zustimmung der zuständigen Ethik-Kommission, im Einklang mit nationalem Recht sowie gemäß der Deklaration von Helsinki von 1975 (in der aktuellen, überarbeiteten Fassung) durchgeführt. Von allen beteiligten Patienten liegt eine Einverständniserklärung vor.

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Authors and Affiliations

  1. Klinik für Internistische Onkologie und Hämatologie, Kliniken Essen-Mitte, Henricistr. 92, 45136 , Essen, Deutschland

    M. Stahl

  2. Kantonsspital St. Gallen, St. Gallen, Schweiz

    T. Ruhstaller

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  1. M. Stahl
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  2. T. Ruhstaller
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Correspondence to M. Stahl.

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Stahl, M., Ruhstaller, T. Multimodale Therapie des Ösophaguskarzinoms. Internist 55, 7–14 (2014). https://doi.org/10.1007/s00108-013-3315-7

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  • DOI: https://doi.org/10.1007/s00108-013-3315-7

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