Zusammenfassung
In den zurückliegenden Jahren hat es bzgl. Diagnostik, Stadieneinteilung und Therapie des Lungenkarzinoms einige Fortschritte gegeben. Dennoch ist es weiterhin die häufigste Todesursache durch Krebserkrankungen. Eine zügige Diagnostik, gefolgt von einer exakten Stadieneinteilung, erlauben multimodale Therapieansätze, die an Lebensalter und Komorbiditäten angepasst werden können. Kurative Operationen sind im Stadium I des nichtkleinzelligen Lungenkarzinoms (NSCLC) möglich und führen zu einem 5-Jahres-Überleben von bis zu 75% aber auch bei fortgeschrittenen T4-Tumoren kann durch eine multimodale Therapie noch ein Langzeitüberleben von 40–50% erreicht werden. Beim nichtkleinzelligen Lungenkarzinom mit Fernmetastasen beträgt die mediane Überlebenszeit jedoch nur noch 8–12 Monate. Insgesamt führen die aktuell verfügbaren multimodalen Therapien bei den meisten Patienten zu einer Lebensverlängerung mit guter Lebensqualität. Zur Palliation kommen bei inoperablen Patienten in hohem Alter Monochemotherapien mit nur geringer Toxizität zum Einsatz. Beim kleinzelligem Lungenkarzinom im Stadium „limited disease“ werden gelegentlich langfristige Remission nach Polychemotherapie beobachtet. Im Stadium „extensive disease“ verlängert diese die Lebenserwartung von 1–2 auf etwa 12 Monate.
Abstract
In previous years numerous advances in diagnostics, staging and therapy of lung cancer have been achieved. Nevertheless, it remains the most frequent cause of death from cancerous diseases. Early diagnosis and exact staging enable multimodal therapy regimens adjusted to age and comorbidities, which result in complete remission in a few and in prolonged survival and good quality of life in most patients. Curative surgery is possible in stage I non-small cell lung cancer (NSCLC) and results in a 5-year survival rates of up to approximately 75%. Using multimodal therapy approaches long-term survival can even be achieved in 40–50% of patients with advanced T4 tumors. However, in NSCLC with distant metastases median survival time is only 8-12 months. In elderly patients with no surgical options low cytotoxic monotherapy can be employed with a palliative intent. In the limited disease stage of small cell lung cancer (SCLC) long lasting remission after polychemotherapy has been observed in a minority of patients. However, in the extensive disease stage polychemotherapy prolongs the survival time of SCLC patients from 1–2 months to approximately 12 months.
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Prasse, A., Waller, C., Passlick, B. et al. Lungenkrebs aus Sicht der Inneren Medizin und Chirurgie. Radiologe 50, 662–668 (2010). https://doi.org/10.1007/s00117-009-1961-5
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DOI: https://doi.org/10.1007/s00117-009-1961-5