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Selektive interne Radiotherapie (SIRT) von Lebertumoren

Selective internal radiotherapy (SIRT) of liver tumors

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Zusammenfassung

Methodische Innovationen

Die SIRT ist ein sicheres und effizientes, minimal-invasives nuklearmedizinisch-radiologisches Verfahren zur Therapie von primären und sekundären nicht resezierbaren Lebertumoren. Beim hepatozellulärem Karzinom (HCC) stellt die SIRT eine gut verträgliche Therapieoption auch in fortgeschrittenem Stadium dar.

Radiologische Standardverfahren

Im Falle einer Pfortaderthrombose ist SIRT eine Alternative zur transarteriellen Chemoembolisation (TACE).

Leistungsfähigkeit

Die Rolle der SIRT beim Downstaging/Bridging zur Transplantation ist vielversprechend. Auch bei sekundären Lebertumoren zeigt die SIRT gute Ansprechraten und ausgezeichnete Verträglichkeit.

Bewertung

Ergebnisse prospektiver randomisierter Studien stehen noch aus, um die in zahlreichen retrospektiven oder prospektiven nichtrandomisierten Studien beschriebene Effektivität zu bestätigen.

Empfehlung für die Praxis

Die Indikation wird im Rahmen eines Tumorboards gestellt.

Abstract

Methodical innovations

Selective internal radiotherapy (SIRT) is a safe and efficacious, minimally invasive procedure to treat primary and secondary unresectable liver tumors. For hepatocellular carcinoma (HCC), SIRT has proven to be a well-tolerated therapy option even in advanced stages of disease.

Standard radiological methods

In cases of portal vein thrombosis SIRT is the alternative to transarterial chemoembolization (TACE).

Performance

The role of SIRT regarding downstaging and bridging to transplantation is promising and SIRT has also been shown to be highly effective and well-tolerated in metastastic liver disease.

Achievements

The results of prospective randomized trials are awaited to prove the efficiency and safety of SIRT described in numerous retrospective and prospective non-randomized studies.

Practical recommendations

The indications are established within the framework of a tumor board.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Hoffmann und H. Duan geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Radiology-Center, Institut für Nuklearmedizin, Lazarettgasse 25, 1090, Wien, Österreich

    M. Hoffmann

  2. Klinische Abteilung für Nuklearmedizin, Universitätsklinik für Radiologie und Nuklearmedizin, Medizinische Universität Wien, Wien, Österreich

    H. Duan

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  1. H. Duan
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  2. M. Hoffmann
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Correspondence to M. Hoffmann.

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Duan, H., Hoffmann, M. Selektive interne Radiotherapie (SIRT) von Lebertumoren. Radiologe 55, 48–52 (2015). https://doi.org/10.1007/s00117-014-2708-5

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  • DOI: https://doi.org/10.1007/s00117-014-2708-5

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