Interventionelle Tumortherapie: Möglichkeiten und Grenzen der Kryotherapie

Zusammenfassung

In den letzten Jahren hat sich die Tumortherapie mittels interventioneller Verfahren zu einem weiteren Werkzeug entwickelt, welches die etablierten Verfahren Operation, Chemotherapie und Strahlentherapie ergänzt. Neben der Tumorembolisation mit Chemotherapie-beladenen (TACE) oder mit Betastrahler-beladenen radioaktiven (SIRT) Partikeln spielen die ablativen Verfahren eine immer größere Rolle. Bei diesen ablativen Verfahren werden dünne Sonden in den lokal begrenzten Tumor eingeführt, um diesen entweder mittels Hitze (Radiofrequenzablation/Mikrowellenablation) oder mittels Kälte (Kryoablation) zu zerstören. Die Vor- und Nachteile der Kryotherapie sollen im Folgenden und anhand von Fallbeispielen dargestellt und diskutiert werden.

Summary

Image-guided tumor ablation has gained widespread acceptance in the last few years for the treatment of many focal malignancies. These new tools for focal tumor treatment are often combined with other well established treatments (systemic chemotherapy, radiation therapy or chemoembolisation). Focal tumor can be destroyed by heat (microwave- or radiofrequencyablation) or by freezing (cryoablation). Technical improvements in the last years led to much smaller diameters of the cryoprobes which made them feasible for percutaneous treatment. Cryoablation is most often used to treat small primary malignancies of the kidney, lung metastases and bone metastases. The main advantages are the lack of significant periprocedural pain and the possibility of monitoring the ablation zone using CT guidance since it creates a visible well demarcated iceball. That allows treatments in the near proximity of critical structures.

Schlüsselwörter

Kryotherapie - Kryoablation - interventionelle Radiologie - minimal-invasive Therapie - Tumorablation

Key words

cryotherapy - cryoablation - interventional radiology - minimal-invasive therapy - tumor ablation

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