Bruch H P
Chirurgische Universitätsklink Würzburg.
Langenbecks Arch Chir. 1987;372:295-9. doi: 10.1007/BF01297831.
Benign tumours, generally, don't cause problems to surgery. For palliative or curative therapy of malignant tumours, scrupulous planning is required whether to apply multimodal or monotherapy, an offensive or a defensive one. Latest study results proved optimal successes with multimodal therapy. Pre-operative radiotherapy, local or systemic chemotherapy, hyperthermic extremity perfusion and, recently, transcatheter embolization are in use. Mostly, sanitation succeeds by radical surgery with lymphadenectomy and distant metastases resection, if necessary, even without mutilations. Post-operative radiotherapy, chemotherapy and hyperthermic extremity perfusion turn against tumour residuals, cells neglected during surgery, micro- and macrometastases. Proximally, specific antibodies against surface antigens of tumour cells will be available. This strategy must even consider a retreat by symptomatic therapy with interferons, radiation, calcitonin, phenol injections and analgesics, in the advanced stages, completed by psychotherapeutic care which enables the patient to accept his disease.
一般来说,良性肿瘤对手术不会造成问题。对于恶性肿瘤的姑息性或根治性治疗,无论采用多模式治疗还是单一疗法,积极治疗还是保守治疗,都需要精心规划。最新研究结果证明多模式治疗取得了最佳效果。目前正在使用术前放疗、局部或全身化疗、肢体热灌注以及最近的经导管栓塞术。大多数情况下,通过根治性手术切除淋巴结并在必要时切除远处转移灶来实现根治,甚至无需进行致残性手术。术后放疗、化疗和肢体热灌注针对肿瘤残留、手术中被忽视的细胞、微转移和宏转移。不久之后,将有针对肿瘤细胞表面抗原的特异性抗体。在晚期,这种策略甚至必须考虑采用对症治疗,如使用干扰素、放疗、降钙素、苯酚注射和镇痛药,同时辅以心理治疗,使患者能够接受自己的病情。