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Multimodale Therapie des kleinzelligen Lungenkarzinoms

Die Rolle der Strahlentherapie

Multimodal therapy of small cell lung cancer

The role of radiotherapy

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Zum Zeitpunkt der Diagnosestellung kleinzelliges Lungenkarzinom (SCLC) sind etwa 30 % der Patienten im Stadium „limited disease“. Dies entspricht in der Maximalausbreitung dem befallenen Hemithorax, dem Mediastinum und den supraklavikulären Lymphknoten. Diese Patienten haben eine kurative Chance durch eine kombinierte thorakale Radiochemotherapie.

Ergebnisse

Die Gesamtbehandlungszeit und frühe thorakale Bestrahlung simultan zur Chemotherapie sind für den Therapieerfolg wichtig. Dagegen scheint eine Dosiseskalation über 45–50 Gy hinaus keinen eindeutigen Vorteil zu bieten. Weiterhin trägt als wichtige Säule auch die prophylaktische Bestrahlung des Gehirns (PCI) bei, die Rate intrakranieller Rezidive zu senken.

Schlussfolgerung

Eine abgestimmte interdisziplinäre, multimodale Radiochemotherapie konnte sich in den letzten Jahren fest etablieren und ist essenziell für den Behandlungserfolg des kleinzelligen Lungenkarzinoms.

Abstract

Background

At the time of diagnosis approximately 30% of patients with small cell lung cancer (SCLC) are at the stage of limited disease with maximum spreading to the hemithorax, the mediastinum and supraclavicular lymph nodes. In this situation combined thoracic chemoradiotherapy plays a significant role in a treatment approach with curative intent.

Results

Total treatment time and early initiation of radiotherapy simultaneously to chemotherapy are prognostically relevant for success of treatment. In contrast, dose escalation beyond 45–50 Gy for thoracic irradiation does not seem to improve survival. Prophylactic cranial irradiation (PCI) is also an important component to reduce brain metastases and increase survival.

Conclusion

A coordinated interdisciplinary, multimodal chemoradiotherapy has become firmly established in recent years and is essential for the success of treatment of SCLC.

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Authors and Affiliations

  1. Klinik und Poliklinik für Strahlentherapie, Universitätsklinikum Würzburg, Würzburg, Deutschland

    M. Flentje & T. Fischer

  2. Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland

    M. Flentje

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Correspondence to M. Flentje.

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M. Flentje und T. Fischer geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Flentje, M., Fischer, T. Multimodale Therapie des kleinzelligen Lungenkarzinoms. Onkologe 23, 360–365 (2017). https://doi.org/10.1007/s00761-017-0208-8

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  • DOI: https://doi.org/10.1007/s00761-017-0208-8

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