Interdisziplinäres Management von Clivuschordomen

Zusammenfassung

Clivuschordome gehören zu den seltenen Tumoren der Schädelbasis. Das aggressive Wachstumsverhalten und der Lagebezug zu kritischen Strukturen erfordern ein interdisziplinäres Management. Im Mittelpunkt der Therapie steht hier die möglichst vollständige Tumorresektion unter Erhalt der neurologischen Funktionen des Patienten. Hierbei bietet sich der endonasale endoskopische Zugang besonders an. Postoperativ wird in der Regel eine adjuvante Therapie mittels Protonenbestrahlung empfohlen, da hiermit auch residuelles Tumorgewebe kontrolliert und das Langzeitüberleben der Patienten verbessert werden kann.

Eine „targeted tumour therapy“ basierend auf den individuellen molekularbiologischen Charakteristiken der Chordome könnte in Zukunft eine neue medikamentöse Therapieoption darstellen.

Abstract

Chordoma of the clivus belong to the rare tumors of the skull base. Due to their aggresive behaviour including intradural infiltration of neurovascular structures an interdisciplinary treatment is mandatory. This article gives an overview on current surgical concepts including the endoscopic approach as well as the postoperative radiotherapy. Novel diagnostic tools and molecular targets to optimize individual tumor therapy are discussed.

Schlüsselwörter

Molekularbiologie - Clivus - Chordom - Endoskopie - Schädelbasischirurgie

Key words

clivus - chordoma - endoscopy - skullbase surgery - molecular biology

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