Lokale und Metastasen -gerichtete Therapieoptionen beim oligometastasierten Prostatakarzinom

Zusammenfassung

Die Weiterentwicklung systemischer Therapiekonzepte beim metastasierten Prostatakarzinom haben in der jüngeren Vergangenheit zu einer deutlichen Prognoseverbesserung geführt. Inwieweit durch lokale und/oder gezielte Metastasen-gerichtete Therapien neben Palliation, lokaler Kontrolle und Funktionserhalt ein zusätzlicher prognostischer Nutzen besteht, war lange unklar. Für die lokale Therapie der Prostata besteht aktuell die höchste Evidenz für die Strahlentherapie und zeigt bei „niedriger Metastasen-Tumorlast“ oligometastasierter Patienten einen signifikanten Überlebensvorteil. Metastasen-gerichtete operative oder radioonkologische Konzepte zeigen ebenfalls Möglichkeiten zur Verbesserung der Prognose auf, sind bislang aber noch unzureichend untersucht und sollten daher immer individuell und interdisziplinär diskutiert, dokumentiert und etabliert werden.

Abstract

New developments of systemic therapy concepts for metastatic prostate carcinoma have led to a significant improvement in the prognosis in the recent past. It has long been unclear to what extent local and/or metastasis-directed therapies have an additional oncologic benefit in addition to palliation, local control and functional maintenance. For local therapy of the prostate, the highest evidence currently exists for radiotherapy and shows a significantly increased overall survival in “low- burden” oligometastatic patients. Metastasis-directed surgical or radio-oncological concepts may also improve prognosis but have not yet been sufficiently investigated and should therefore be discussed, documented and established on an individual and interdisciplinary basis.

Schlüsselwörter

Prostatakarzinom - Oligometastasierung - Strahlentherapie - Metastasen-gerichtete Therapie

Keywords

prostate cancer - external beam radiation - metastasis-directed therapy - oligometastasis

Publication History

Article published online:
09 February 2021

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