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7. Tabellenverzeichnis
Tab. 1: T-Klassifikation von Kopf-Hals-Tumoren nach dem TNM-System der
UICC, [Wittekind(2010)] ... 11
Tab. 2: N-Klassifikation von Kopf-Hals-Tumoren nach dem TNM-System der UICC, [Wittekind (2010)] ... 11
Tab. 3: M-Klassifikation von Kopf-Hals-Tumoren nach dem TNM-System der UICC, [Wittekind (2010)] ... 12
Tab. 4: Histologischer Differenzierungsgrad (Grading) (Wittekind 2010) ... 12
Tab. 5: UICC-Stadieneinteilung von Kopf-Hals-Tumoren (Wittekind 2010) ... 12
Tab. 6: Patientencharakteristika der beiden Gruppen ... 28
Tab. 7: Therapiedurchführung und Verlauf der Therapien ... 32
Tab. 8: TPF-Gruppe (n = 40); Remissionsstaus nach der TPF-Therapie ... 32
Tab. 9: TPF-Gruppe (n = 40); Remissionsstatus nach der RCT- bzw. RIT-Therapie oder alleiniger RT ... 33
Tab. 10: RCT-Gruppe (n = 45); Remissionsstatus nach der RCT- bzw. RIT-Therapie ... 34
Tab. 11: Akute hämatogene Toxizität nach CTCAE-Graden; TPF-Gruppe (n = 40); (während der TPF-Therapie) ... 40
Tab. 12: Akute hämatogene Toxizität nach CTCAE-Graden; TPF-Gruppe (n = 40); (während/nach der RCT- oder RIT-Therapie) ... 41
Tab. 13: Akute nicht-hämatogene Toxizität nach CTCAE-Graden; TPF-Gruppe (n = 40); (während/nach der RCT- oder RIT-Therapie) ... 41
Tab. 14: Hämatogene Toxizität nach CTCAE-Graden; (RCT-Gruppe (n = 45); (während/nach der RCT- oder RIT-Therapie) ... 42
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Tab. 15: Akute nicht-hämatogene Toxizität nach CTCAE-Graden; RCT-Gruppe (n = 45); (während/nach der RCT- oder RIT-Therapie) ... 43 Tab. 16: Späte nicht-hämatogene Toxizität nach CTCAE-Graden; TPF- Gruppe (n = 40); (nach der RCT- oder RIT-Therapie) ... 43 Tab. 17: Späte nicht-hämatogene Toxizität nach CTCAE-Graden; RCT-Gruppe (n = 45); (nach der RCT- oder RIT-Therapie) ... 44
8. Abbildungsverzeichnis
Abb. 1: Kaplan-Meier-Kurve des Gesamtüberlebens des Patientenkollektivs (n = 85) ... 35 Abb. 2: Kaplan-Meier-Kurve des Gesamtüberlebens der beiden Therapiegruppen ... 36 Abb. 3: Kaplan-Meier-Kurve des lokoregionär-rezidivfreien Überlebens der beiden Therapiegruppen ... 37 Abb. 4: Kaplan-Meier-Kurve des metastasenfreien Überlebens der beiden Therapiegruppen ... 38 Abb. 5: Kaplan-Meier-Kurve des krankheitsfreien Überlebens der beiden Therapiegruppen (DFS = Disease Free Survival) ... 39
9. Abkürzungsverzeichnis
Amp. Ampulle
AUC Area Under the Curve
B[a]P Benzo[a]pyren
AZ Allgemeinzustand
bzw. beziehungsweise
bzgl. bezüglich
CR Komplette Remission
CT Computertomographie
CTC Common Toxicity Criteria
CTV Clinical target volume
DFS Disease Free Survival
dl Deziliter
EBV Ebstein-Barr-Virus
ECE Extracapsular Extension
ED Einzeldosis
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EGFR Epidermal Growth Factor Receptor
5-FU 5-Fluoruracil
g Gramm
G-CSF Granulozyten-Kolonie-stimulierender Faktor
GD Gesamtdosis
GTV Gross tumor volume
Gy Gray
Hb Hämoglobin
HNO Hals-Nasen-Ohrenheilkunde
HPV humaner Papillomavirus
HSV Herpes simplex Virus
H2 Histaminrezeptortyp
5-HT3 5-Hydroxytryptamin 3
IMRT Intensitätsmodulierte Radiotherapie
ICT Induktionschemotherapie
KOF Körperoberfläche
LAW Lymphabflusswege
m² Quadratmeter
mg Milligramm
MKG Mund-Kiefer-Gesichtschirurgie
MRT Magnetresonanztomographie
NaCl Natriumchlorid
o.g. oben genannten
PD Progressive Disease/Tumorprogress
PEG Perkutane endoskopische Gastrostomie
PF Cisplatin / 5- Fluoruracil
PR Partielle Remission
PTV Planning target volume/Zielvolumen
RECIST Response Evaluation Criteria In Solid Tumors
RCT Radiochemotherapie
RIT Radioimmuntherapie
RT Radiotherapie
s.c. subcutan
SD Stable Disease/kein Tumoransprechen
SIB Simultan integrierter Boost
SPSS Statistical Package for the Social Sciences TPF Docetaxel / Cisplatin / 5-Fluoruracil
TNM Tumor / Nodus (Lymphknoten) / Metastasen
u.a. unter anderem
UICC Union internationale contre le cancer
UK United Kingdom
USA United States of America
v.a. vor allem
WHO World Health Organization
w.o. wie oben
z.B. zum Beispiel
63
10. Eidesstattliche Versicherung
„Ich, Elife Berisha, versichere an Eides statt durch meine eigenhändige Unterschrift, dass ich die vorgelegte Dissertation mit dem Thema: „Vergleich der Therapieergebnisse bei lokal fortgeschrittenen Kopf-Hals-Tumoren mit und ohne Induktionschemotherapie (ICT) vor primär kurativer Radiochemotherapie (RCT) oder Radioimmuntherapie (RIT)“ selbstständig und ohne nicht offengelegte Hilfe Dritter verfasst und keine anderen als die angegebenen Quellen und Hilfsmittel genutzt habe.
Alle Stellen, die wörtlich oder dem Sinne nach auf Publikationen oder Vorträgen anderer Autoren beruhen, sind als solche in korrekter Zitierung (siehe „Uniform Requirements for Manuscripts (URM)“ des ICMJE -www.icmje.org) kenntlich gemacht.
Die Abschnitte zu Methodik (insbesondere praktische Arbeiten, Laborbestimmungen, statistische Aufarbeitung) und Resultaten (insbesondere Abbildungen, Graphiken und Tabellen) entsprechen den URM (s.o) und werden von mir verantwortet.
Die Bedeutung dieser eidesstattlichen Versicherung und die strafrechtlichen Folgen einer unwahren eidesstattlichen Versicherung (§156,161 des Strafgesetzbuches) sind mir bekannt und bewusst.“
Datum 27.05.2017 Unterschrift
64
11. Danksagung
An dieser Stelle möchte ich mich ganz herzlich bei allen bedanken, die beim Zustandekommen dieser Dissertation beigetragen haben.
Vielen Dank an Herrn PD Dr. med. Pirus Ghadjar für die stetige Unterstützung bis zur Fertigstellung dieser Arbeit.
Ein ganz besonderer Dank gilt Herrn Dr. med. Lutz Moser, der mich mit dem Thema vertraut gemacht hat und mit seiner motivierenden Art zur Verwirklichung dieser Arbeit beigetragen hat.
Mein Dank gilt auch Herrn Prof. Dr. med. Dr. h.c. Volker Budach für seine stetige und umsichtige Unterstützung.
Ebenso danke ich meiner Familie, die mir jederzeit Unterstützung, Hilfe und Verständnis beim Gelingen meiner Arbeit entgegengebracht hat.