Müller Jörg Andreas, Trommer Simon, Meyer Frank, Lampe Katharina, Croner Roland S, Vordermark Dirk, Medenwald Daniel
Universitätsklinik und Poliklinik für Strahlentherapie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.
Klinik für Allgemein‑, Viszeral‑, Gefäß- und Transplantationschirurgie, Universitätsklinikum Magdeburg A. ö. R., Leipziger Str. 44, 39120, Magdeburg, Deutschland.
Chirurgie (Heidelb). 2023 May;94(5):441-452. doi: 10.1007/s00104-023-01820-1. Epub 2023 Mar 9.
Radiotherapy is an integral component of most modern multimodal tumor treatment concepts, both in palliative and curative situations and intentions. This also applies to many tumor entities relevant in general as well as abdominal surgery. This can give rise to new challenges in the context of the daily clinical routine and interdisciplinary tumor conferences.
Practice relevant overview, based on selective references from the current scientific literature in medicine and own experiences obtained in daily work, for the oncological surgeon on radiotherapy-associated options for visceral tumor lesions. A particular focus is on rectal cancer, esophageal cancer, anal cancer and liver metastases.
A narrative review is given.
RESULTS (SELECTED CORNER POINTS): In total neoadjuvant therapy it is possible to avoid resection in rectal cancer if a good response is achieved and close monitoring can be provided. In esophageal cancer neoadjuvant chemoradiotherapy followed by resection can be considered the therapeutic regimen of choice for all suitable patients. If surgery is not an option, definitive chemoradiotherapy is an appropriate and favorable alternative, especially with respect to squamous cell carcinoma. Even taking the latest data on the topic into account, definitive chemoradiotherapy remains undisputedly recommended for anal cancer. Liver tumors can be locally ablated by stereotactic radiotherapy.
Close cooperation between disciplines in the context of tumor therapy remains essential for the best possible treatment and outcome of patients.
放射治疗是大多数现代多模式肿瘤治疗理念不可或缺的组成部分，无论是在姑息治疗还是根治性治疗的情况下和意图中。这也适用于许多一般相关以及腹部手术中相关的肿瘤实体。这可能会在日常临床工作和跨学科肿瘤会议中带来新的挑战。
基于医学领域当前科学文献中的选择性参考文献以及日常工作中获得的自身经验，为肿瘤外科医生提供关于内脏肿瘤病变放疗相关选择的实践相关概述。特别关注直肠癌、食管癌、肛管癌和肝转移瘤。
进行叙述性综述。
结果（选定要点）：在直肠癌的新辅助治疗中，如果取得良好反应并能进行密切监测，则有可能避免手术切除。在食管癌中，新辅助放化疗后进行手术切除可被视为所有合适患者的首选治疗方案。如果手术不可行，根治性放化疗是一种合适且有利的替代方案，尤其是对于鳞状细胞癌。即使考虑到关于该主题的最新数据，根治性放化疗对于肛管癌仍然无可争议地被推荐。肝脏肿瘤可通过立体定向放射治疗进行局部消融。
在肿瘤治疗中，各学科之间的密切合作对于患者获得最佳治疗和结果仍然至关重要。
