Zusammenfassung
Perkutane Strahlentherapie ist in der Therapie von Knochenmetastasen durch die direkte Antitumor- und antiinflammatorische Wirkung messbar effektiv (Verbesserung der Lebensqualität durch Schmerzlinderung, lokaler Tumorwachstumsstillstand). Indikationen zur lokalen Bestrahlung sind Schmerzen, Frakturgefahr, manifeste Fraktur sowie Kompression durch den Tumor, aber auch operative Interventionen am Knochen. Knochenmetastasen werden mit Strahleneinzeldosen zwischen 2 Gy und 8 Gy, bei Gesamtdosen zwischen 8 Gy und 50 Gy behandelt, die Dauer der Therapie schwankt zwischen einem Tag (Einzeitbestrahlung) und 5 Wochen. Die Ansprechraten bei Schmerz werden je nach Entität mit 60–90% angegeben (bei großen Skelettvolumina 60%). Die röntgenologisch nachweisbare Rekalzifizierung variiert zwischen 5% und 70%. Die Kombination mit antiosteoklastischen Substanzen bringt Therapievorteile. Die Ansprechraten bei Re-Bestrahlung betragen 60%.
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Adamietz, I. (2014). Strahlentherapie der Knochenmetastasen. In: Stenzl, A., Fehm, T., Hofbauer, L., Jakob, F. (eds) Knochenmetastasen. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-43471-0_7
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