Vielfalt erfordert Interdisziplinarität

Ohne Zusammenfassung     

Interdisziplinarität in der Onkologie

Insufficient cooperation across specialties, sectors, and professions disturbs adequate medical care for tumor patients. Through numerous initiatives, legislators have tried to promote interdisciplinary and transsectoral medical care. Interdisciplinarity fails in practice because of economic competition. In particular, in view of our society’s demographic background, politicians are obliged to enable interdisciplinary cooperation in a barrier-free way. Therefore, essential changes in the healthcare system are necessary. Because of medical–ethical interests, physician groups are obliged to contribute to the configuration of health care and to bring concepts such as interdisciplinarity to life.     

Sarkompatienten profitieren von Interdisziplinarität und Teamarbeit

best practice onkologie -     

Interdisziplinarität ist unverändert das Gebot der Stunde

Ohne Zusammenfassung     

Seltene gynäkologische Tumoren

Apart from the common gynaecological carcinomas there exist a large number of rare non-epithelial malignant tumours. In this context, ovarian stromal cell tumours account for 5% and germinal cell tumours of the ovary for 15% of ovarian neoplasms. Uterine sarcomas represent only 2-3% of all rare genital malignancies. The standard non-epithelial ovarian tumour therapy is in many cases a fertility-conserving operation. However, in advanced stages a debulking operation is required analogue to the therapy of ovarian tumours. In this situation adjuvant BEP chemotherapy with platinum should be carried out. The basic module in the treatment of uterine sarcomas calls for a radical operative procedure which can be followed up with post-operative platinum-based chemotherapy. In contrast gestational trophoblastic disease should primarily be treated by chemotherapy.     

Qualitätssicherung in der Onkologie am Beispiel des Mammakarzinoms der Feldstudie München

Die Feldstudie München ist eines von 8 Modellprojekten in Deutschland, gef?rdert vom Bundesministerium für Gesundheit (BMG), welche fl?chendeckend anhand von Tracerdiagnosen Verfahren zur Qualit?tssicherung und zum Qualit?tsmanagement entwickeln und erproben. Die beiden Tracerdiagnosen in München sind das Mamma- und Rektumkarzinom, wobei im Folgenden beispielhaft auf das Mammkarzinom eingegangen wird. Die medizinische Versorgung soll beschrieben, ggf. die Qualit?t optimiert werden. Die Feldstudie München wurde in die etablierte Kooperation des Tumorzentrum München (TZM) integriert und agiert somit in enger Zusammenarbeit mit dem Tumorregister, den Projektgruppen “Mammkarzinome” und “Gastrointestinale Tumoren” des TZM sowie den regionalen Standesvertretungen.     

Immuntherapien bei gynäkologischen Tumoren

best practice onkologie - Die Anwendungsgebiete von Immuncheckpointinhibitoren haben sich in den letzten Jahren enorm erweitert. Auch bei gynäkologischen Krebserkrankungen ist das Interesse an...     

Spätfolgen von Tumoren im Kindesalter

Background

Currently, 80?% of all childhood cancer cases are cured. However, results from recent research have raised the question of whether the cured patients are healthy. The risk for long-term complications in this cancer patient cohort depends on diagnosis and treatment modalities. In particular, children with brain tumors often have complications later in life.

Results

Long-term follow-up results from pediatric cancer survivors in the USA report that two thirds of all cured patients experience at least one complication within 30 years of the curative cancer treatment. Respective data for pediatric cancer survivors in Germany are not available. Scheduling regular examinations in the children’s hospital in accordance with follow-up guidelines are recommended to rule out relapse or later complications. This concept, however, does not adequately meet the physical and psychological needs of grown or young adult patients. To meet the needs of this growing patient group and maintain high quality in long-term follow-up, special aftercare programs must be developed in which the pediatric oncologist cooperates with specialists in internal medicine and other areas appropriate for the patient. Each patient needs an individualized, risk-adapted (to both disease and treatment) follow-up schedule to ensure early detection of possible later complications.

Conclusions

Maintaining health and quality of life in patients of all ages after curative cancer treatment will not only be socially important, but have an economic impact on society in the future.

     

Stammzelltransplantation bei pädiatrischen soliden Tumoren

Die Onkologie - Die Hochdosischemotherapie mit autologem Stammzellsupport, auch autologe Stammzelltransplantation (SZT) genannt, hat seit ihrer Einführung zur Behandlung solider Tumoren eine...     

Qualität und Quantität

Ohne Zusammenfassung     

Allogene Stammzelltransplantation bei pädiatrischen soliden Tumoren

High-dose chemotherapy followed by autologous hematopoietic stem cell transplantation has been established for the treatment of several forms of pediatric tumors. However, patients with metastatic relapse or specific high risk groups still have a poor prognosis. It is an ongoing matter of debate if these patients may benefit from potential graft versus tumor (GvT) effects after allogenic stem cell transplantation. Although previous non-randomized retrospective studies with a limited number of patients were not able to show an advantage for allotransplants, there is clear experimental or clinical evidence for the existence of GvT effects. Moreover, since transplant-related toxicity has markedly improved in recent years, ongoing clinical trials have to re-evaluate the role of contemporary approaches for allotransplantation. German studies are focusing on immunological effects exerted by haploidentical family donors and on additional posttransplantation immunotherapy.     

Seltene Tumoren als Leitsymptom hereditärer Tumorsyndrome

best practice onkologie - Monogen erbliche Tumorsyndrome bzw. Tumordispositionssyndrome (TDS) beruhen auf Keimbahn-/konstitutionellen Mutationen in Schlüsselgenen der Karzinogenese. Ein...     

Fertilitätserhalt bei Tumoren im Kindes- und Jugendalter

Die Onkologie - Die spätere Kinderwunscherfüllung von Patient*innen mit Tumoren im Kindes- und Jugendalter kann aufgrund ihrer Erkrankung und deren Therapie eingeschränkt sein....