Thermochemotherapie mit Mitomycin C: Update zur Therapiealternative beim nicht-muskelinvasiven Harnblasenkarzinom

Zusammenfassung

Das Harnblasenkarzinom ist die zweithäufigste urologische Tumorerkrankung. Je nach Tumorstadium und Tumorgrad stehen unterschiedliche Behandlungskonzepte zur Verfügung, um Rezidiv- und Progressionsrate der Erkrankung zu minimieren. Alternative Therapieverfahren nach Versagen der Instillationstherapie mit Mitomycin C oder BCG rücken gerade in Zeiten von Ressourcenknappheit (BCG) erneut in das Interesse. Schwierig ist es derzeit, eine endgültige Aussage über Effektivität und Sicherheit dieser alternativen Verfahren zu machen.

Die hier vorliegende Übersichtsarbeit stellt die derzeit verfügbaren thermotherapeutischen Therapieverfahren (elektroinduktiv und elektrokonduktiv) vor. Ausgehend von der ersten Veröffentlichung zur Thermochemotherapie mit Mitomycin C (Synergo ^® ) bis hin zur ersten vergleichenden Studie zwischen Thermochemotherapie mit Mitomycin C und der klassischen Instillationstherapie mit BCG. Dazu werden neue elektrokonduktive Verfahren wie Combat ^® und Unithermia ^® vorgestellt.

Abschließend werden auf Basis der aktuellen Datenlage die Anwendungsbereiche diskutiert, zu der die Thermochemotherapie mit Mitomycin C derzeit in der Lage ist.

Abstract

Bladder cancer is the second most common urological malignant disease. There are various treatment strategies which, depending on tumor stage and grade, can minimize recurrence and lower progression rate. Alternative treatment modalities of instillation therapy after failure with first line Mitomycin C or BCG do exist and have become a point of interest, especially in times of shortage of agents such as BCG.

This article aims to give an overview of the current existing thermotherapeutic treatment options (electroinductive and electroconductive). The article starts with the first publication presenting thermochemotherapy with Mitomycin C using the Synergo ^® device and highlights the first randomized controlled study comparing Mitomycin C (Synergo ^® ) with conventional BCG therapy. The article also presents data about first conductive Mitomycin C therapy using the new Combat ^® and the Unithermia ^® device.

Finally, it discusses in which cases thermotherapy with Mitomycin C can be applied safely based upon the current available data.

Schlüsselwörter

Harnblasenkarzinom - Thermochemotherapie - Mitomycin C - BCG - Instillationstherapie

Keywords

bladder cancer - thermochemotherapy - Mitomycin C - bcg - instillation therapy

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