{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:42:01Z","timestamp":1765546921644},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T00:00:00Z","timestamp":1652659200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Medizinische Fakult\u00e4t Heidelberg der Universit\u00e4t Heidelberg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["HNO"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:sec>\n                <jats:title>Hintergrund<\/jats:title>\n                <jats:p>Derzeit gilt das gr\u00f6\u00dfere, nicht mehr durch Teilresektionen behandelbare T3-Larynxkarzinom als optimaler Kandidat f\u00fcr einen Larynxorganerhalt (LP) mittels prim\u00e4rer Radiochemotherapie (pRCT). Wann w\u00e4re eine prim\u00e4re Strahlentherapie (pRT) ggf. auch ohne Chemotherapiezusatz vertretbar, und wann selbst beim T3 doch eher die totale Laryngektomie mit risikoadaptierter adjuvanter Therapie (TL\u00b1aR[C]T) zu empfehlen?<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methodik<\/jats:title>\n                <jats:p>In der Literatur wurde nach Parametern gesucht, die bei nichtrandomisierten zweiarmigen LP-Studien als Kriterium f\u00fcr den Einschluss in den chirurgischen anstelle des konservativen Arms genannt wurden oder die sich nach konservativer Therapie als signifikante Prognosemarker herausstellen. Hieraus Entwicklung eines Beratungsinstruments f\u00fcr die Therapieentscheidung.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Ergebnisse<\/jats:title>\n                <jats:p>Als signifikante Prognosemarker beschrieben wurden das Tumorvolumen, das Vorhandensein und die Art der Stimmbandfixierung, das Ausma\u00df der Knorpelinfiltration, der N\u2011Status und die laryngeale Dysfunktion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Diskussion<\/jats:title>\n                <jats:p>Beim T3-Larynxkarzinom scheint eine reine pRT vertretbar zu sein, wenn das Volumen &lt;\u202f3,5 ccm f\u00fcr glottische bzw. &lt;\u202f6 ccm f\u00fcr supraglottische Tumoren betr\u00e4gt und keine weiteren Risikofaktoren vorliegen. Die pCRT kann als Standard des konservativen LP bei Tumoren mit einem Volumen zwischen 6\u202fccm und 12\u202fccm gelten, bei einer Stimmbandfixierung Succo\u00a0I\/II, einer allenfalls minimalen Knorpelinfiltration und einer hohen nodul\u00e4ren Tumorlast. Bei Tumoren mit einem Volumen &gt;\u202f12\u00a0ccm, einem Stimmbandfixierungsmuster Succo\u00a0III\/IV, ausgedehnter oder multipler Knorpelinfiltration oder relevanter laryngealer Dysfunktion sollte prim\u00e4r die TL\u00b1a[C]RT empfohlen werden.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00106-022-01177-7","type":"journal-article","created":{"date-parts":[[2022,5,16]],"date-time":"2022-05-16T15:02:52Z","timestamp":1652713372000},"page":"581-587","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Organerhalt: Entscheidungskriterien f\u00fcr Patienten mit T3-Larynxkarzinom"],"prefix":"10.1007","volume":"70","author":[{"given":"Gerhard","family":"Dyckhoff","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf","family":"Warta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christel","family":"Herold-Mende","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter K.","family":"Plinkert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heribert","family":"Ramroth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,5,16]]},"reference":[{"key":"1177_CR1","unstructured":"Bootz F (2019) S3-Leitlinie Diagnostik, Therapie und Nachsorge des Larynxkarzinoms. https:\/\/www.awmf.org\/uploads\/tx_szleitlinien\/017-076OLl_S3_Larynxkarzinom_2019-11.pdf. 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