Feste Größe im Therapieplan - Radioonkologische Therapiekonzepte zur Behandlung des Bronchialkarzinoms

Zusammenfassung

Die Radiotherapie hat in der meist multimodalen Behandlung des Bronchialkarzinoms einen festen Stellenwert. Beim nichtkleinzelligen Bronchialkarzinom (NSCLC) wird sie vor allem im inoperablen Stadium III A und im Stadium III B eingesetzt - bei Patienten im guten Allgemeinzustand in der Regel als simultane oder sequenzielle Radiochemotherapie. Die verbesserten Ergebnisse solcher kombinierter Therapieansätze gehen meist mit einer erhöhten therapiebedingten Toxizität einher. Postoperativ sollte eine Radiotherapie beim nichtkleinzelligen Bronchialkarzinom bei nicht kompletter Resektion (R1, R2) sowie pN2-Situation erfolgen. Zudem kann sie bei der lokalen Behandlung des Stadiums IV, in der Notfallbehandlung sowie bei der Behandlung von Hirnmetastasen des nichtkleinzelligen Bronchialkarzinoms das Überleben der Patienten verlängern sowie deren Lebensqualität verbessern. Bei der Behandlung des kleinzelligen Bronchialkarzinoms kommt die Radiotherapie vor allem im Stadium „limited disease” als Konsolidierung nach systemischer Chemotherapie zum Einsatz.

Summary

Radiotherapy has an essential significance in the multimodal treatment of non-small cell and small cell lung cancer. For non-small cell lung cancer (NSCLC) radiotherapy is mainly applied in inoperable Stage III A and Stage III B disease. According to current studies patients in good general conditions will receive a simultaneous or sequential radiochemotherapy. A simultaneous radiochemotherapy should be performed in protocols. The better outcome of a combined radiochemotherapy is associated with a higher acute toxicity. In the postoperative situation, patients with an incomplete resection (R1, R2) or pN2-situation should also receive radiotherapy. Furthermore, radiotherapy improves survival and quality of live for patients with non-small cell lung cancer in the treatment of stage IV disease, emergency situations and brain metastases. In the treatment of small cell lung cancer (SCLC) stage limited disease radiotherapy is performed after chemotherapy for consolidation of the primary tumor site.

radiotherapy - lung cancer - review - non-small cell - small cell

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1 postoperative radiotherapy in non-small-cell lung cancer

2 international adjuvant lung cancer trial

3 continous hyperfractionated accelerated radiotherapy

4 european organisation for research and treatment of cancer

5 cancer and leukemia group B

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