Diagnostik und Therapie des Neuroblastoms

Zusammenfassung

Das Neuroblastom ist der häufigste extrakranielle solide Tumor des Kindesalters. Der Verlauf der Erkrankung kann sehr variabel sein. Im Säuglingsalter können Spontanremissionen sogar bei metastasierter Erkrankung auftreten, während das 5-Jahres-Überleben älterer Kinder mit metastasierter Erkrankung nur bei etwa 40% liegt. Wichtige prognostische Faktoren sind das Alter des Patienten bei Diagnosestellung, das Erkrankungsstadium sowie molekulargenetische Marker. Die vorliegende Arbeit gibt einen Überblick über einige wichtige molekulargenetische Marker, die klinische Symptomatik, die Stadieneinteilung, die erforderliche Diagnostik und die Therapie. Die Behandlung des Neuroblastoms muss risikoadaptiert erfolgen. Bei lokalisierten Tumoren ist unter bestimmten Voraussetzungen eine operative Tumorentfernung ausreichend. Bei metastasierten Tumoren und/oder bei Vorliegen von Risikofaktoren ist neben der Operation meist eine intensive Chemotherapie, gegebenenfalls in Kombination autologer Stammzelltransplantation und/oder mit Strahlentherapie erforderlich.

Summary

Neuroblastoma is the most common extracranial solid tumour of childhood. The prognosis depends on many factors. In infants, neuroblastoma can regress spontaneously even in metastatic disease. In children over 1 year, the 5 year survival is only about 40%. Important risk factors are age at diagnosis, disease stage, and molecular markers. The article gives an overview over some important molecular markers, clinical symptoms, staging, diagnostic procedures, and treatment. The treatment of neuroblastoma must be risk-adapted. In most localized tumors, resection is the only treatment. In risk-patients, intensive treatment including tumour resection, high dose chemotherapy, and in some cases autologous stem cell transplantation and/or radiotherapy are necessary.

Schlüsselwörter

Neuroblastom - solide Tumoren im Kindesalter - Diagnostik - Chemotherapie

Keywords

Neuroblastoma - childhood tumours - diagnosis - chemotherapy

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