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Dtsch Med Wochenschr 2015; 140(14): 1063-1068
DOI: 10.1055/s-0041-102333
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Chronische Lebererkrankungen
© Georg Thieme Verlag KG Stuttgart · New York

Das hepatozelluläre Karzinom – Therapieoptionen 2015

Hepatocellular Carcinoma: therapeutic options 2015
Michael Schultheiß
1   Klinik für Innere Medizin, Universitätsklinikum Freiburg
,
Dominik Bettinger
1   Klinik für Innere Medizin, Universitätsklinikum Freiburg
,
Hannes P. Neeff
1   Klinik für Innere Medizin, Universitätsklinikum Freiburg
,
Thomas B. Brunner
1   Klinik für Innere Medizin, Universitätsklinikum Freiburg
,
Robert Thimme
1   Klinik für Innere Medizin, Universitätsklinikum Freiburg
› Author Affiliations
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Publication History

Publication Date:
16 July 2015 (online)

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Zusammenfassung

Das hepatozelluläre Karzinom (HCC) ist eine häufige Tumorerkrankung mit zunehmender Inzidenz und einer schlechten Prognose. Bei der Therapieentscheidung müssen zahlreiche Faktoren, wie z. B. Größe und Anzahl der Tumoren, die Leberfunktion, die Folgen einer portalen Hypertension oder Begleiterkrankungen berücksichtigt werden. Dies spiegelt sich in der Barcelona Clinic Liver Cancer (BCLC) -Klassifikation wieder. Als kurative Therapien für das frühe, lokalisierte Stadium gelten die Resektion, Radiofrequenzthermoablation (RFTA) und Lebertransplantation. Im intermediären Stadium kommt die transarterielle Chemoembolisation (TACE), seltener eine selektive interne Radiotherapie (SIRT) oder – als off-label – eine stereotaktische Körper-Radiotherapie (SBRT) zum Einsatz. Sorafenib steht als einzige systemische Therapie im fortgeschrittenen Stadium zur Verfügung. Alternative Behandlungsmethoden, wie z. B. immunologische Therapieansätze, werden derzeit untersucht.

Abstract

The incidence of hepatocellular carcinoma (HCC), a common neoplasm, is rising and the prognosis is poor. Many factors have to be taken into account when deciding on the best mode of therapy, like tumor size and number, liver function, sequelae of portal hypertension or other comorbidities. These factors are reflected in the Barcelona Clinic Liver Cancer (BCLC) classification. Resection, radiofrequency ablation (RFA) and liver transplantation can be seen as curative therapies for the early and localized HCC. For the intermediate state of the HCC, there are other therapeutic modalities in therapy available: transarterial chemoembolization (TACE), selective internal radiation therapy (SIRT, rarer occasions), off label: stereotactic body radiation therapy (SBRT). At the moment, Sorafenib is the only option in treating advanced stages of HCC. Alternative treatment strategies, like e. g. immunological therapies, are being investigated.

Schlüsselwörter

hepatozelluläres Karzinom (HCC) - Barcelona Clinic Liver Cancer (BCLC)-Klassifikation - Sorafenib

Keywords

hepatocellular carcinoma (HCC) - Barcelona Clinic Liver Cancer (BCLC) classification - Sorafenib
 

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