Optimierung der Strahlentherapieplanung bei lokal fortgeschrittenen NSCLC durch ¹⁸F-FDG PET-CT: Stand der PET-Plan-Studie

Zusammenfassung

Während bei inoperablen Patienten mit einem NSCLC im Stadium I und II die hoch dosierte stereotaktische Strahlentherapie eine kurative Option mit hohen lokalen Kontrollraten darstellt, sind die strahlentherapeutischen Möglichkeiten in fortgeschrittenen Stadien limitiert. Durch die Fortschritte in der moderne Strahlentherapie konnten die Therapieergebnisse bei konventionell fraktionierter simultaner Radiochemotherapie mit der Standard-Gesamtdosis von 60 (– 66 Gy) verbessert werden. Der unumstrittene Nutzen und die hohe Zahl an Patienten, für die die simultane Radiochemotherapie eine kurative Option darstellt, erklärt die Notwendigkeit weitere Studien zur kontinuierlichen Verbesserung der Therapieergebnisse. Die PET-Plan-Studie greift die Erkenntnisse der letzten Jahrzehnte zu Chemotherapie und optimierter Strahlentherapie auf und prüft den Vorteil einer Dosiseskalation bei PET-basierter Bestrahlungsplanung hinsichtlich Verbesserung der lokalen Tumorkontrolle und Verringerung der Normalgewebstoxizität.

Abstract

In inoperable patients with early-stage NSCLC stereotactic body radiation therapy is associated with high local tumor control rates, whereas radiotherapy for locally advanced NSCLC leaves room for improvement. The advances in modern radiotherapy with high-quality treatment planning and delivery led to better outcomes of pa­tients treated with simultaneous radio-chemotherapy in conventional fractionation and doses of 60 (-66) Gy.

The obvious benefit and high number of patients eligible for radio-chemotherapy illustrate the need for clinical trials to advance therapy for ­future patients. The PET-Plan-Trial evaluates if an intensification of radiotherapy dose by means of a ¹⁸F-FDG-PET confined radio-chemotherapy ­optimizes local tumor control and reduces toxicity.

Schlüsselwörter

NSCLC - Radiochemotherapie - Dosiseskalation - PET-Plan-Studie

Key words

NSCLC - radiochemotherapy - dose escalation - PET-Plan Trial

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