Lokale Tumortherapie – Was empfehlen die Leitlinien?

Kurzfassung:

Medicine, in some instances more than other fields, undergoes a constant development process, making guidelines and standard operative procedures an important tool for the medical community. This is especially true in oncology, a discipline for which multidisciplinarity and combined therapies are essential for optimized patients'care and better outcomes. Principles of clinical guidelines should be based on current scientific evidences with participants coming from different medical societies and by default on the consensus of medical experts, also called good clinical practices. Moreover, high-quality guidelines are necessary not only for a structured knowledge transfer, but they also find their place in the structures of the health system, becoming more and more a reference for discussions with reimbursement institutes and insurance companies. Finally, evidence-based guidelines serve as a basis to define quality indicators that will be used for the certification process of comprehensive cancer centers as well as for creating and updating of disease management programs for all medical practitioners. If one refers to the number of papers focused on IR, we are forced to admit that interventional oncology is taking a large place. Major reason is that over the last 30 years, interventional oncology has not only developed effective palliative monotherapies such as TACE and SIRT for hepatic tumours, but has also achieved curative treatments by treating with thermal ablation selected patients presented with kidney, liver or lung cancer. Nevertheless, international recommendations of expert societies do not seem to recognize the real value of interventional oncology. Thus, the role of interventional oncology is accepted and established almost only for the treatment of patients presented with HCC without cirrhosis and in some palliative clinical situations.

Lernziele:

Klinische Relevanz der interventionellen Onkologie. Kritische Sicht der internationalen Leitlinien