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Therapie des Lungenkarzinoms

Treatment of lung cancer

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Zusammenfassung

Die Lungenkarzinome werden wegen therapeutischer Konsequenzen in kleinzellige (SCLC) und nichtkleinzellige (NSCLC) Tumoren eingeteilt. Die Therapie richtet sich weiterhin nach dem TNM-Stadium. Ebenso werden Funktionseinschränkungen, Komorbiditäten und Allgemeinzustand mit berücksichtigt. Da die Ergebnisse bis jetzt unbefriedigend und viele Fragen offen sind, sollten die Patienten möglichst in Studien behandelt werden. Beim SCLC erfolgt immer eine Polychemotherapie, bei lokal beschränkten Tumoren zusätzlich früh eine thorakale Strahlentherapie und bei guter Remission eines SCLC eine prophylaktische Schädelbestrahlung. In den operablen Stadien des NSCLC zeichnet sich die Kombination mit einer adjuvanten Therapie und in den lokal fortgeschrittenen Stadien die Radiochemotherapie als adäquate Behandlung ab. Im metastasierten Stadium kommt eine Polychemotherapie zum Einsatz. Geeignete Patienten werden auch im Rezidiv einer systemischen Therapie zugeführt.

Abstract

For therapeutic reasons lung cancer is classified as small cell (SCLC) or non-small cell lung cancer (NSCLC). Therapy is further guided by the TNM stage, functional impairment, comorbidities and the performance status. As the results of therapy to date are disappointing and many questions remain unresolved, as many patients as possible should be included in prospective trials. In SCLC polychemotherapy is mandatory; in local tumour stages radiotherapy should be combined early on with chemotherapy, and in cases of marked remission, prophylactic cranial irradiation is indicated. In operable stages of NSCLC adjuvant chemotherapy demonstrates a survival benefit. In locally advanced NSCLC, radiochemotherapy is now the standard of care. Advanced stages require chemotherapy usually with two drugs; second-line chemotherapy or targeted therapy is indicated in cases of relapse.

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Interessenkonflikt

Der korrespondierende Autor weist auf folgende Beziehungen hin: Der Autor Prof. Dr. Huber führt klinische Studien mit Präparaten der Firmen Amgen, AstraZeneca, Boehringer Ingelheim, Lilly, Merck, Novartis, SanofiAventis und Roche durch, ist dabei teilweise beratend tätig und hält ebenso Vorträge zu diesen Themen.

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  1. Pneumologie, Klinikum der Universität München – Innenstadt, Ziemssenstraße 1, 80336, München, Deutschland

    R.M. Huber

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  1. R.M. Huber
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Correspondence to R.M. Huber.

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Huber, R. Therapie des Lungenkarzinoms. Pneumologe 5, 259–266 (2008). https://doi.org/10.1007/s10405-008-0223-y

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  • DOI: https://doi.org/10.1007/s10405-008-0223-y

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