Interventionell-radiologische Therapien in der pneumologischen Onkologie

Zusammenfassung

Interventionell-radiologische Verfahren zur Behandlung von primären und sekundären pulmonalen Malignomen gewinnen zunehmend an Bedeutung. Neben thermisch abladierenden Verfahren ermöglicht die selektive Instillation von Zytostatika und Embolisaten über vaskuläre Zugänge eine lokal begrenzte Therapie. Die Therapien kommen für Patienten, bei denen ein reduzierter Allgemeinzustand keine systemische Chemotherapie zulässt, palliativ in Betracht. Bei funktionell inoperablen Patienten sind insbesondere die ablativen Verfahren eine potenziell kurative Alternative zur Operation. Dieser Artikel soll eine Übersicht über die derzeit angewandten interventionell-radiologischen Verfahren in der pneumologischen Onkologie und ihren Stellenwert geben. Ob die aufgrund ihres günstigen Risiko-Nutzen-Verhältnisses vielversprechenden interventionell-radiologischen Verfahren möglicherweise eine Alternative zur strahlentherapeutischen Behandlung darstellen oder in multimodalen Konzepten überlegen sind, müssen Studien zeigen.

Abstract

Interventional radiological procedures for the treatment of primary and secondary pulmonary malignancies have become increasingly important. In addition to thermally ablative treatment, selective chemoembolisation by a vascular access allows localised therapy. These treatments are considered to be palliative for patients in a reduced general condition which does not allow systemic chemotherapy. In functionally inoperable patients especially the ablative procedures are potentially curative alternatives to surgery. This article provides an overview of the currently used interventional radiological procedures in lung oncology and assesses their importance. Further studies are needed to show whether interventional radiological procedures, which are promising due to their favourable risk–benefit ratio, may represent an alternative to radiotherapy or be effective in multimodal approaches.

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