Radio-Onkologie Beim Rektum- Und Anal-Karzinom
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In den letzten 20 lahren hat sich ein grundlegender Wandel in den Erkenntnissen fiber die Therapiemethoden von Rektal- und Analkarzinomen vollzogen. Der Wissensstand fiber die Entstehungsgeschichte und das pathologische Ver- halten dieser Tumoren ist erheblich groBer geworden. Gleichzeitig hat die Strahlentherapie einen wesentlichen Stel- lenwert bei der Behandlung dieser Tumorarten erlangt. In der vorliegenden Abhandlung faBt Werner Dobrowsky unter Verwendung von Daten aus der Fachliteratur und aus seiner eigenen Erfahrung die jfingsten Entwicklungen der Strahlentherapiemethoden zusammen, die in Verbindung mit einem chirurgischen Eingriff oder al1ein eingesetzt werden. Er zeigt auf, daB wir uns an einem Wendepunkt in der Be- handlungsstrategie von Rektal- und Analkarzinomen be- finden. In den Kapiteln, die sich mit dem Rektalkarzinom befassen, untersucht Dobrowsky die allgemeinen Merkmale der Krank- he it und das Problem der Friiherkennung, bevor er sich mit der Lokalisierung der Strahlentherapie als unterstiitzende Therapie nach einem chirurgischen Eingriff oder als Allein- therapie befaBt. Er weist auf die Vorteile hin, die eine praope- rative Strahlenbehandlung in den meisten Fallen biete- nicht nur durch die Erhohung der lokalen Tumorkontrolle, sondern auch durch die Aufrechterhaltung der Analfunktion beim Patienten. Der Autor macht aber deutlich, wie not- wen dig gerade in diesem Zusammenhang ein Klima des Ver- trauens zwischen Chirurgen und Strahlentherapeuten ist.
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