Zusammenfassung
Das hepatozelluläre Karzinom (HCC) ist weltweit einer der häufigsten malignen Tumoren
mit steigender Inzidenz auch in westlichen Ländern. Unbehandelt ist die Prognose außerordentlich
ungünstig. Zur Therapie des HCCs stehen chirurgische und nicht-chirurgische Verfahren
zur Verfügung. Resektion und in ausgewählten Fällen die Lebertransplantation sind
die einzigen potenziell kurativen Therapieverfahren. Nicht-chirurgische Therapiemöglichkeiten
sind lokal-interventionelle und transarterielle Verfahren. Eine Reihe von alternativen
Therapiestrategien wie die medikamentöse Therapie mit antiangiogenetischen, antiproliferativen
oder antiinflammatorischen Substanzen, Immuntherapeutika, gentherapeutische Ansätze
und die interne bzw. externe Bestrahlung werden derzeit auf ihre Wirksamkeit untersucht,
das Überleben bzw. das Rezidiv-freie Überleben der Patienten mit HCC zu verlängern.
Diese Arbeit soll einen Überblick über die aktuellen alternativen Therapiemöglichkeiten
beim HCC geben.
Abstract
Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some
areas of the world. The prognosis of HCC patients is generally very poor with a 5-year
survival rate of less than 5 %. Therapeutic strategies include surgery (resection
or liver transplantation) and non-surgical interventions, such as percutaneous ethanol
injection or radiofrequency thermal ablation as well as transarterial embolization
or chemoembolization. Therefore, the development and evaluation of novel HCC treatment
strategies such as the use of antiangiogenic, antiproliferative or antiinflammatoric
drugs, immune therapeuticals, gene therapy and internal or external radiation are
of utmost importance. This review should give an overview of possible alternative
therapies in HCC treatment.
Schlüsselwörter
hepatozelluläres Karzinom - Immuntherapie - Gentherapie - Antiangiogenese - medikamentöse
Therapie
Key words
hepatocellular carcinoma - immune therapy - gene therapy - antiangiogenesis - drug
therapy
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PD Dr. H. C. Spangenberg
Abteilung Innere Medizin II · Medizinische Universitätsklinik · Albert-Ludwigs-Universität
Freiburg
Hugstetter Straße 55
79106 Freiburg
eMail: spangenberg@med1.ukl.uni-freiburg.de