Bildgesteuerte Strahlentherapie des Prostatakarzinoms

Zusammenfassung

Die intensitätsmodulierte Strahlentherapie (IMRT) hat die Möglichkeit zur geometrisch differenzierten Applikation hoher Bestrahlungsdosen auf Prostataloge, Prostata und Samenblasen prinzipiell verbessert. Ein dokumentiertes Risiko hochkonformaler Bestrahlungsverfahren besteht jedoch in der Reduktion der Sicherheitsabstände bei mobilen Zielorganen wie der Prostata. Moderne, nicht invasive Lokalisationsverfahren sind daher nötig, um die konformale Bestrahlung des Prostatakarzinoms unter Schonung des Rektums weiter zu optimieren. Diese Übersicht fasst die neuen Möglichkeiten der so genannten „bildgesteuerten Strahlentherapie” (Image Guided Radiotherapy, IGRT) zusammen, durch die die Lokalisation des Zielvolumens für die Strahlentherapie weiter verbessert werden kann.

Abstract

Intensity modulated radiotherapy (IMRT) has improved the capability to apply geometrically individualised high radiotherapy doses to the prostate bed, prostate and seminal vesicles. A high risk of geometrical miss with conformal methods, however, has been documented for mobile targets such as the prostate. Modern, non-invasive localisation techniques are therefore mandatory to further optimise conformal radiotherapy for prostate cancer. This review summarises technological advances related to “image-guided radiotherapy” (IGRT) which will further improve target positioning in prostate cancer radiotherapy.

Schlüsselwörter

Prostatakarzinom, - intensitätsmodulierte Strahlentherapie, - IMRT, - bildgesteuerte Strahlentherapie, - IGRT, - Tumorlokalisation, - Patientenpositionierung

Key words

prostate cancer, - intensity modulated radiotherapy, - IMRT, - image-guided radiotherapy, - IGRT, - tumour localisation, - patient positioning

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