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Hauttumoren

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Strahlentherapie

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Zusammenfassung

Das Basalzellkarzinom (Basaliom, BCC ) ist das häufigste, das Plattenepithelkarzinom (Spinaliom, spinozelluläres Karzinom, SSC) das zweithäufigste Hautkarzinom. Die Inzidenz nimmt weltweit seit 1964 mit 3–8 % pro Jahr zu. Jährlich werden 0,9-1,2 Mio. neue Fälle allein in den USA diagnostiziert - 18-20 mal mehr als maligne Melanome (Diepgen u. Mahler 2002) - und 2000 Tote an nicht-melanomatösen Hautkarzinomen registriert (Tsang u. O’Sullivan 2001). Die für 2010 in USA geschätzte Fallzahl liegt bei mehr als 2 Mio. und die Behandlungskosten in der Medicare-Patientengruppe überschreitet 400 Mio. USD (Bichakjian et al. 2013). In Europa sind 10 %, in Australien 50 % aller Krebserkrankungen Hautkarzinome. Während in Europa 100 Basalzellkarzinome und 20–30 spinozelluläre Karzinome pro 100.000 Einwohner diagnostiziert werden, liegt die Inzidenz in Australien bei 900 bzw. bei 250 pro 100.000. Sie hat von 1985–2002 um 133 % bzw. 35 % zugenommen (Staples 2003). Das Durchschnittsalter der Patienten liegt zwischen 50 und 70 Jahren. Die Häufigkeit des Auftretens bei Männern und Frauen ist bei Basaliomen gleich und bei Spinaliomen 2:1. Mehr als 90 % der Tumoren entwickeln sich in sonnenexponierten Körperregionen wie im Kopf-Hals-Bereich und an den Armen. Insbesondere in den beiden ersten Lebensjahrzehnten ist UV-Einstrahlung der wichtigste ätiologische Faktor für Karzinome im Alter. Weitere Faktoren sind exogene Noxen wie Arsen, Teer, ionisierende Strahlung, hochdosierte PUVA (Psoralene plus UV-A)-Therapie und chronische Reizungen in Narbengewebe. Auch genetische Faktoren wie Albinismus, blonder Pigmentationstyp , Xerodermia pigmentosa und das Gorlin-Goltz-Syndrom begünstigen die Entwicklung maligner Hauttumoren (Ping et al. 2001). Immunsuppression nach Organtransplantation erhöht die Inzidenzrate für Basalzellkarzinome auf das 10fache und für Plattenepithelkarzinome auf das 250fache im Vergleich zur Normalbevölkerung (Menaker u. Chiu 2001). Basaliome wachsen ohne erkennbare Vorstufen, während Plattenepithelkarzinome aus Präkanzerosen (aktinische oder Arsenkeratosen, Morbus Bowen) oder auf vorgeschädigter Haut entstehen können.

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Authors and Affiliations

  1. Kallmorgenstr. 8b, D-76229, Karlsruhe, Deutschland

    W. Haase

  2. Heinrich-Weitz-Str. 37, 76228, Karlsruhe, Deutschland

    K. Reisner

  3. Klinik für Strahlentherapie und Radiologische Onkologie, St. Vincentius Kliniken, Steinhäuserstr. 18, D-76135, Karlsruhe, Deutschland

    J. Claßen

Authors
  1. W. Haase
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  2. K. Reisner
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  3. J. Claßen
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  1. Universitätsklinikum Heidelberg, Heidelberg, Germany

    Michael Wannenmacher

  2. Universitätsklinikum Mannheim, Mannheim, Germany

    Frederik Wenz

  3. Universitätsklinikum Heidelberg, Heidelberg, Germany

    Jürgen Debus

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Haase, W., Reisner, K., Claßen, J. (2013). Hauttumoren. In: Wannenmacher, M., Wenz, F., Debus, J. (eds) Strahlentherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-88305-0_32

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  • DOI: https://doi.org/10.1007/978-3-540-88305-0_32

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