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Multimodale Therapie des lokal fortgeschrittenen nichtkleinzelligen Bronchialkarzinoms (Stadium IIIa/IIIb)

Multimodality treatment of local advanced non-small cell lung cancer (stage IIIa/IIIb)

  • Themenschwerpunkt: Onkologische Thoraxchirurgie
  • Published:
Acta Chirurgica Austriaca Aims and scope Submit manuscript

Zusammenfassung

Grundlagen

Die unbefriedigenden Ergebnisse und die schlechten Überlebensraten nach alleiniger chirurgischer Behandlung lokal fortgeschrittener nichtkleinzelliger Bronchialkarzinome (Stadium IIIa und IIIb), haben dazu geführt, daß weltweit der Einfluß einer systemischen Chemotherapie bzw. Chemo-/Strahlentherapie präoperativ überprüft werden sollte. Die meisten Studien betrafen Patienten im Stadium IIIa, einige wenige schlossen beide Stadien IIIa und IIIb ein.

Methodik

Die hier vorgestellte Studie beinhaltete eine präoperative Chemotherapie mit Cisplatin/Etoposid und hyperfraktionierte Strahlentherapie mit 45 Gy, gefolgt von der Resektion.

Ergebnisse

Die multimodale Therapie war tolerable, die Remissionsraten hoch (66,7%), die Toxizität niedrig. Eine R0-Resektion konnte bei 82% der operierten Patienten erzielt werden. Die mediane Überlebenszeit lag bei 20 Monate für das Stadium IIIa und 21 Monate für das Stadium IIIb.

Schlußfolgerungen

Diese intensive präoperative neoadjuvante Therapie für das lokal fortgeschrittene NSCLC erwies sich so effektiv, daß bereits eine randomisierte, prospektive Studie für das Stadium IIIa begonnen wurde.

Summary

Background

The poor results and survival of patients with local advanced non small cell lung cancer (NSCLC) after surgery has led worldwide to an evaluation of the role of chemotherapy or chemo-/radiotherapy before operation.

Methods

From March 1991 to March 1994 patients with local advanced NSCLC (mediastinoscopy obligatory) have been entered into an ongoing trial with preoperative chemotherapy and simultaneous chemo-/radiotherapy, followed by remediastinoscopy and surgery.

Results

Clinical response rates after chemo/radiotherapy amounted to 66.7% no severe toxicity was observed. A complete resection (R0) reached 82% of the resected patients. Median survival time ranged between 20 months for stage IIIa and 21 months for IIIb disease.

Conclusions

This intensive preoperative neoadjuvant treatment is tolerable and high effective, so that a randomised comparative trial for stage IIIa disease was already started.

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Authors and Affiliations

  1. Inneren Klinik und Poliklinik des Westdeutschen Tumorzentrums der Universitätsklinik Essen, Deutschland

    W. Eberhardt & H. Wilke

  2. Klinik für Strahlentherapie der Universitätsklinik Essen, Deutschland

    W. Budach & M. Stuschke

  3. Abteilung für Thoraxchirurgie und thorakale Endoskopie der Ruhrlandklinik, D-45239, Essen, Deutschland

    G. Stamatis

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  1. G. Stamatis
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  2. W. Eberhardt
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  3. H. Wilke
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  4. W. Budach
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  5. M. Stuschke
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Stamatis, G., Eberhardt, W., Wilke, H. et al. Multimodale Therapie des lokal fortgeschrittenen nichtkleinzelligen Bronchialkarzinoms (Stadium IIIa/IIIb). Acta Chir Austriaca 28, 82–85 (1996). https://doi.org/10.1007/BF02602608

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