Palliative Strahlentherapie – Notfallindikation und schonende Therapie zur Symptomlinderung

Abstract

Even if cure of a malignant disease cannot be achieved, palliative radiotherapy often alleviates or resolves symptoms and prevents complications thus facilitating a good quality of life. Palliative radiotherapy differs in some principal matters from curative radiotherapy. First, there is a different treatment goal. Second, total dose, fractionation, treatment time, and tolerable side effects vary substantially. Tumor or metastases related pain is the main field for palliative radiotherapy. Especially for metastatic bone disease, radiotherapy is the most effective treatment modality in reducing pain, preventing pathological fractures, and allowing re-stabilization of the bone. Another sphere for palliative radiotherapy are tumor caused compressionsyndromes. These include intracerebral pressure due to cerebral metastases, spinal cord compression, vena cava superior syndrome, compression of the esophagus, the tracheal-bronchial system, ureter or bile ducts causing dysphagia, dyspnea, urinary or bile retention and others. The most frequent indications for palliative radiotherapy are bone and cerebral metastases. The most common emergency indications are spinal cord compression and vena cava superior syndrome.