Durchbruch in Hautkrebsbehandlung: Schmerzfrei und ohne Skalpell

Neue Therapiemethode bei den Barmherzigen Brüdern in Graz

Rehenium-188 nennt sich bei den Barmherzigen Brüdern Graz die neue Therapiemethode bei weißem Hautkrebs am Institut für Nuklearmedizin, geleitet von Primaria Dr. Gabriela Binder-Pötsch. Damit ist eine Behandlung ohne Skalpell möglich – also ohne Narkose und Operation!

„Die lokale Therapie mit Rhenium-188 eignet sich zur Behandlung von weißem Hautkrebs, insbesondere Basalzell- und Plattenepithelkarzinomen“, erklärt Dr. Gabriela Binder-Pötsch. „Diese Tumore werden meist operativ entfernt, was an lichtexponierten Stellen wie Kopf und Hals aufwendig und kosmetisch einschränkend sein kann. Alternativen zur OP sind etwa Kryotherapie, Laserablation, photodynamische Therapie, Salben oder Strahlentherapie. Mit der schmerzfreien Rhenium Skin Cancer Therapy (ReSCT) steht eine weitere Option ohne operativen Eingriff zur Verfügung.“

„Wenn man schon einmal ein Basalzellkarzinom oder ein Plattenepithelkarzinom hatte, ist auch die Wahrscheinlichkeit hoch, dass dieses erneut auftritt“, beschreibt Primaria Binder-Pötsch die Situation vieler Patientinnen und Patienten, was unter Umständen eine neuerliche Operation erschwert.

Zum Ablauf erklärt sie: Nach Zuweisung über die HNO-Abteilung diagnostiziert der Kliniker, führt eine Biopsie durch und plant die Nachkontrollen. „Wir müssen im Vorfeld wissen, wie tief der Krebs in die Haut wächst. Das Rhenium- 188 ist ein Beta-Strahler mit einer Eindringtiefe von zwei bis drei Millimetern und eignet sich somit gut für oberflächliche Hauttumore. Wurde im Vorfeld alles abgeklärt, kommt der Patient am Therapietag zuerst zum HNO-Arzt in unsere Ambulanz. Hier wird die zu behandelnde Stelle mit einem Stift umrissmarkiert. Anschließend kommt er zu uns in die Nuklearmedizin. Wir bringen eine dünne Folie auf die Haut auf. Auf diese Folie wird dann im markierten Bereich eine radioaktive Paste mit einem speziellen Applikator aufgetragen.“

Nach einer errechneten Einwirkzeit (abhängig von Größe und Tiefe des Hauttumors) wird die Folie samt der Paste abgezogen und der Patient kann im Anschluss das Institut verlassen. Es braucht keine Narkose, keine Anästhesie. Die einzige wirkliche Einschränkung ist eine bestehende oder vermutete Schwangerschaft. Mit der Folie wird auch die radioaktive Strahlenquelle entfernt und somit gibt es auch keine weitere Strahlenbelastung mehr für die Patienten.

Die medizinische Wirkung der Rhenium-SCT basiert auf der lokalen direkten zellzerstörenden Wirkung der Beta-Strahlung, welche sowohl den lokalen Zelltod, als auch in weiterer Folge eine lokale Reaktion des körpereigenen Abwehrsystems auslöst.

Die Therapie wird ambulant durchgeführt. In der Regel ist eine einmalige Anwendung ausreichend. Die Nebenwirkungen sind gering und beschränken sich auf das Behandlungsareal. Die vollständige Heilung kann bis zu 3 Monate dauern, selten auch bis zu 6 Monate.

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