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Medikamentöse Therapie des Nebennierenkarzinoms

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Medication treatment of adrenocortical carcinoma

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Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Das Nebennierenkarzinom ist eine seltene Erkrankung mit ungünstiger Prognose und variablem Verlauf. Neben der möglichst vollständigen Resektion als wichtigste Therapie werden verschiedene medikamentöse Optionen eingesetzt.

Ziel

Neben den gängigen medikamentösen Therapieoptionen wird in diesem Artikel der aktuelle Stand zu zielgerichteten Therapieoptionen beleuchtet.

Material und Methoden

Selektive Literaturrecherche (PubMed) sowie Auswertung des eigenen Patientenkollektivs.

Ergebnisse und Diskussion

Unter den verschiedenen medikamentösen Therapieoptionen stellt Mitotan – trotz vieler Nebenwirkungen – weiterhin die Therapie der ersten Wahl sowohl im adjuvanten Setting als auch bei der fortgeschrittenen Erkrankung dar. Im weiteren Verlauf wird Mitotan bei Progress oder initial schon aggressiver Erkrankung um Chemotherapeutika (z. B. Kombination von Etoposid, Doxorubicin, Cisplatin) ergänzt. Die weitere Behandlung ist dann sehr vom individuellem Erkrankungsverlauf, der Höhe der ggf. vorliegenden Tumorlast und des Allgemeinzustands des Patienten abhängig.

Abstract

Background

Adrenocortical carcinoma is a rare disease with an unfavorable prognosis and a variable course. In addition to as complete a resection as possible as the most important treatment, there are various options for medication treatment.

Objective

In addition to the established medicinal treatment options, this article summarizes the current state of the various options of medicinal treatment for patients with adrenocortical carcinoma.

Material and methods

Selective research of literature (PubMed) and evaluation of data from our own patients.

Results and discussion

Among the various forms of pharmaceutical treatment, mitotane is still the treatment of first choice in an adjuvant setting and in advanced disease, despite many side effects. In patients with an aggressive disease even in the initial stages or progression, mitotane is combined with other chemotherapeutic agents, such as etoposide, doxorubicine and cisplatin. Further treatment options depend on the individual course of the disease, the extent of tumor load and the general condition of the patient.

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Authors and Affiliations

  1. Medizinische Klinik und Poliklinik I, Schwerpunkt Endokrinologie&Diabetologie, Universitätsklinikum Würzburg, Universität Würzburg, Oberdürrbacher Str. 6, 97080, Würzburg, Deutschland

    Felix Megerle &  Martin Fassnacht

Authors
  1. Felix Megerle
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  2. Martin Fassnacht
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Corresponding author

Correspondence to Felix Megerle.

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Interessenkonflikt

M. Fassnacht ist Koordinator der aktuell von der European Society of Endocrinology und dem European Network for the Study of Adrenal Tumors in Auftrag gegebenen Evidenz-basierten Leitlinien zum Nebennierenkarzinom. F. Megerle gibt an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Megerle, F., Fassnacht, M. Medikamentöse Therapie des Nebennierenkarzinoms. Onkologe 24, 118–123 (2018). https://doi.org/10.1007/s00761-017-0312-9

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  • DOI: https://doi.org/10.1007/s00761-017-0312-9

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