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Deutsche Zeitschrift für Onkologie 2017; 49(02): 68-77
DOI: 10.1055/s-0043-110184
Forschung
© Karl F. Haug Verlag in MVS Medizinverlage Stuttgart GmbH & Co. KG

Metronome Chemotherapiekonzepte

Concepts of Metronomic Chemotherapy
Marcus Schmidt
,
Johannes Ettl
,
Tobias Pukrop
,
Albrecht Reichle
Further Information

Publication History

Publication Date:
18 July 2017 (online)

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Zusammenfassung

Erfolgreichere Therapien für Patienten mit metastasierten Karzinomen zu entwickeln, bleibt eine Herausforderung. In der palliativen Situation ist bei allen Wünschen an die Wirksamkeit immer auch die Lebensqualität zu berücksichtigen. Hier bietet das Konzept der metronomen Chemotherapie einen guten Ansatz, da hierdurch eine bessere Balance zwischen Wirksamkeit und Verträglichkeit erreicht werden kann. Grundelemente der metronomen Chemotherapie sind die regelmäßige Gabe von Zytostatika in niedriger Dosis mit dem Ziel einer wirksamen und gut verträglichen Therapie. Studien mit metronomer Chemotherapie bei metastasiertem Mammakarzinom weisen sogar auf eine vergleichbare Effektivität wie mit konventioneller Chemotherapie und eine geringere Toxizität hin. Dieser Übersichtsartikel fasst das Wissen um diese Form der Therapie zusammen und bezieht auch wesentliche Mechanismen des Tumorgeschehens – der Metastasierung, der Interaktion von Tumor und Stroma sowie der körpereigenen Tumorabwehr – mit ein, um die Wirkungsweise der metronomen Chemotherapie besser verstehen zu lernen.

ABSTRACT

It is still a challenging endeavour to develop more successful therapies for patients with metastatic carcinoma. Especially during the palliative stage, the desire for more effective therapy also has to take into account the quality of life of the patient. In this regard, the concept of metronomic chemotherapy offers a good approach because it enables the achievement of a better balance between efficacy and tolerability. The basic elements of metronomic chemotherapy are the regular administration of cytotoxic drugs in low doses with the objective of an effective and well-tolerated treatment. Studies of metronomic chemotherapy in metastatic breast cancer have exhibited the same effectiveness as well as lower toxicity compared with conventional chemotherapy. This review article summarizes the current state of knowledge of this form of therapy. This includes the significant mechanisms of tumour activity (i. e. metastasis, the interaction between tumour and stromal cells as well as the body's tumour defence) in order to better understand the mechanism of action of metronomic chemotherapy.

Schlüsselwörter

metronome Chemotherapie - Palliation - Antiangiogenese - Immunstimulation - Mammakarzinom

Key words

metronomic chemotherapy - palliative care - anti-angiogenesis - immune stimulation - breast cancer
 

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