{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:29:47Z","timestamp":1730870987855,"version":"3.28.0"},"reference-count":17,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n     Wirbelk\u00f6rper sind eine der h\u00e4ufigsten Metastasenlokalisationen beim fortgeschrittenen Prostatakarzinom. Einerseits schr\u00e4nken Wirbels\u00e4ulenmetastasen durch begleitende R\u00fcckenschmerzen die Lebensqualit\u00e4t der Patienten stark ein, andererseits k\u00f6nnen Sekund\u00e4rkomplikationen auftreten, die mit schwerwiegenden neurologischen Ausfallerscheinungen und Funktionsverlusten einhergehen. Neben der Schmerzreduktion stellen zum einen die lokale Tumorkontrolle, zum anderen die Wiederherstellung der spinalen Stabilit\u00e4t zentrale Therapieziele dar. Der Stellenwert der Chirurgie, der konventionellen Strahlentherapie und stereotaktischen Strahlentherapie, sowohl alleinstehend als auch kombiniert, wird vor diesem Hintergrund in der Literatur kontrovers diskutiert. Insbesondere der NOMS-Score erweist sich als hilfreiches Tool zur therapeutischen Entscheidungsfindung. Daten zeigen bessere postoperative Patientenoutcomes nach chirurgischer Therapie, sowohl wenn isoliert durchgef\u00fchrt als auch kombiniert mit der Strahlentherapie, wobei ein Teil der untersuchten Patientenkollektive andere Primaria neben dem Prostatakarzinom miteinschlie\u00dfen. Vergleichsstudien, die speziell im Setting des metastasierten Prostatakarzinoms die \u00dcberlegenheit bestimmter Therapien vergleichen, sind rar. Dasselbe gilt in Bezug auf mikrochirurgische Eingriffe an spinalen Metastasen. Die isolierte Strahlentherapie nimmt insbesondere im Setting der Palliation zur Schmerzlinderung ihren Stellenwert ein, wobei ihre Effektivit\u00e4t zahlreich belegt ist. Therapeutisch entscheidungsf\u00fchrend ist die erwartete Lebensprognose der Patienten. Ein multimodaler Therapieansatz ist vor dem Hintergrund des komplexen Patientenkollektivs vonn\u00f6ten, wobei aktuelle Therapietrends vor dem Hintergrund der Fr\u00fcherkennung spinaler Metastasen gro\u00dfz\u00fcgiger eine operative Intervention integrieren.\n    <\/jats:p>","DOI":"10.1055\/a-2099-1847","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T23:10:31Z","timestamp":1695856231000},"page":"50-53","source":"Crossref","is-referenced-by-count":0,"title":["Akuter Querschnitt unter Systemtherapie \u2013 Radiotherapie oder OP?"],"prefix":"10.1055","volume":"55","author":[{"given":"Lidija","family":"Ujkic","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Orthop\u00e4die, Unfallchirurgie und plastisch-\u00e4sthetische Chirurgie, Uniklinik K\u00f6ln, K\u00f6ln, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo","family":"Sutanto","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Radioonkologie, 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