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Therapie des kleinzelligen Lungenkarzinoms

Treatment of small-cell lung cancer

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Zusammenfassung

Die Therapie des kleinzelligen Lungenkarzinoms orientiert sich an dem Stadium der Erkrankung. Während im lokal begrenzten Stadium (UICC I–III) eine Kombination einer cisplatinhaltigen Chemotherapie und einer möglichst simultanen thorakalen Strahlentherapie Behandlungsstandard ist, erfolgt im metastasierten Stadium die Behandlung mit einem etablierten Chemotherapieschema. Nach Abschluss der Chemotherapie und Ansprechen des Tumors gehört eine adjuvante Strahlentherapie des ZNS bei entsprechendem Allgemeinzustand zum therapeutischen Konzept. Bei Patienten in sehr frühen Tumorstadien ohne Nachweis einer Lymphknotenmetastasierung kann ein operatives Vorgehen in Kombination mit einer ergänzenden Chemotherapie geprüft werden. Im Rezidiv haben Zweitlinienchemotherapien z. B. mit dem Topoisomerase-I-Inhibitor Topotecan Wirksamkeit gezeigt. Molekular zielgerichtete Therapieansätze sowie kontinuierliche Erhaltungstherapien – sei es in Form von Zytostatika oder immunologischen Therapiemaßnahmen – haben bisher keinen erkennbaren Vorteil gezeigt.

Abstract

Treatment of small cell lung cancer (SCLC) is based on the stage of disease. While combination of chemo- and radiotherapy preferably as concomitant chemoradiotherapy represents standard treatment in patients with locally advanced tumors (UICC stage I–III), patients with metastatic disease (stage IV) should be treated with an established platinum based chemotherapy regimen. After chemotherapy and in case of an achieved tumor response treatment should be completed by an adjuvant radiation of the brain in patients with adequate performance status. In patients with a very early stage of disease without involvement of lymph node metastasis a surgical approach in combination with an adjuvant chemotherapy can be discussed. In patients with relapsed tumors second line therapies like the topoisomerase I inhibitor Topotecan have proven efficacy. Up to now neither molecular targeted therapies nor cytotoxic or immunological maintenance strategies have provided any benefit to patients with SCLC.

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Authors and Affiliations

  1. Krankenhaus Großhansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Wöhrendamm 80, 22927, Großhansdorf, Deutschland

    M. Reck

  2. Medizinische Klinik III, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland

    S. Bohnet

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Reck, M., Bohnet, S. Therapie des kleinzelligen Lungenkarzinoms. Internist 52, 130–137 (2011). https://doi.org/10.1007/s00108-010-2696-0

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