Zusammenfassung
Ist eine kurative Therapie aufgrund des lokal fortgeschrittenen oder metastasierten Primärbefundes nicht mehr möglich oder wünscht der Patient bei lokal begrenzter Erkrankung keine kurative Behandlungsoption, kommen palliative Therapiekonzepte zum Tragen. Aufgrund des häufig langsamen Erkrankungsverlaufs kann diese palliative Phase beim Prostatakarzinom viele Jahre umfassen. Bei relevanten Begleiterkrankungen begrenzen häufig konkurrierende Todesursachen die Lebenserwartung. Die Hormontherapie stellt den Standard der palliativen Therapie dar. Im kastrationsresistenten Stadium haben sich in den letzten Jahren neben der Chemotherapie eine Vielzahl neuer Substanzen etabliert, für die eine gute Symptomkontrolle sowie eine Verbesserung des medianen Gesamtüberlebens nachgewiesen werden konnte. Neben neuen Ansätzen zur Hormonmanipulation erweitern auch immunologische und nuklearmedizinische Ansätze das therapeutische Spektrum. Ergänzende Supportivmaßnahmen und eine angepasste Schmerztherapie haben während der gesamten Erkrankungsdauer einen sehr hohen Stellenwert. Vor allem zur Behandlung von symptomatischen Metastasen kommt hierbei der Strahlentherapie eine wichtige Rolle zu.
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Huber, J. et al. (2016). Prostatakarzinom: Palliative Therapie. In: Michel, M., Thüroff, J., Janetschek, G., Wirth, M. (eds) Die Urologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39940-4_144
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