Zusammenfassung
Neben der chirurgischen Therapie von Kopf-Hals-Tumoren wird heutzutage vor allem bei lokal fortgeschrittenen Stadien von Oropharynxkarzinomen eine organ- und funktionserhaltende Therapie angestrebt. Gegenstand aktueller prospektiver Studien ist der direkte Vergleich zwischen Induktionschemotherapie plus Radiochemotherapie (RCT) und einer primär konkomitanten RCT. Neue Ansätze von Kombinationen aus Radio(chemo)therapie und Target-Therapeutika werden ebenfalls in klinischen Studien untersucht. Molekularbiologische Parameter und potenzielle neue therapeutische Targets werden in zahlreichen Studien evaluiert. Die günstige Prognose HPV-positiver Tumoren führt zu dem Wunsch, aktuelle Therapieregime zu deintensivieren, um den Patienten unnötige Toxizitäten zu ersparen. Die Bedeutung spezifischer Therapien nimmt aufgrund der stetig steigenden Inzidenz an HPV-positiven Karzinomen bei jungen Patienten zu.
Abstract
Beside the surgical treatment of head and neck cancer, the concept of organ and function preserving therapy of locally advanced HNSCC (head and neck squamous cell carcinoma) especially of oropharyngeal origin is becoming increasingly important. The comparison of induction chemotherapy plus chemoradiation and primary concomitant chemoradiation has recently been the subject of randomized clinical trials. New combinations of different (chemo)radiation regimens and targeted therapies are also under investigation for HNSCC. Molecular markers predicting treatment efficacy as well as new potential targets are also being evaluated in several clinical trials. The good prognosis of HPV-associated HNSCC has sparked efforts to deintensify treatment to minimize therapy-related toxicities. The impact of specific therapies is growing due to the increasing incidence of young patients with HPV-positive carcinomas.
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Interessenkonflikt
Der korrespondierende Autor weist auf folgenden Beziehung(en) hin: Chia-Jung Busch gibt an, dass kein Interessenkonflikt vorliegt. R. Knecht ist Mitglied des Advisory Boards von Merck Serono, Sanofi Aventis, Boehringer Ingelheim und Bayer Healthcare Leverkusen. S. Laban hat von Bayer Healthcare Sorafenib-Reinsubstanz für präklinische Studien erhalten.
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Loewenthal M und Vitez E haben gleichermaßen zum Inhalt des Artikels beigetragen.
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Loewenthal, M., Vitez, E., Laban, S. et al. Neue Aspekte zur aktuellen Therapie von Oropharynxkarzinomen. HNO 60, 951–956 (2012). https://doi.org/10.1007/s00106-012-2597-8
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DOI: https://doi.org/10.1007/s00106-012-2597-8