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Palliativmedizinische Aspekte beim kleinzelligen Lungenkarzinom

Palliative medical aspects of small-cell lung cancer

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Der Onkologe Aims and scope

Zusammenfassung

Hintergrund

Das kleinzellige Lungenkarzinom (SCLC) ist ein aggressiv wachsender Tumor mit ungünstiger Prognose. Bislang existieren wenige Daten zur Effektivität palliativmedizinischer Interventionen bei der Erkrankung.

Methode

Selektive Literaturrecherche.

Ergebnisse

Im Vergleich zu anderen Tumorerkrankungen besteht eine ausgeprägtere und schwerere tumorassoziierte Beschwerdesymptomatik. Paraneoplastische Syndrome treten beim SCLC gehäuft auf. Durch Hirnmetastasierung und die meist indizierte prophylaktische Schädelbestrahlung kann es im Krankheitsverlauf zu deutlichen kognitiven Beeinträchtigungen kommen. Diese krankheitsspezifischen Besonderheiten machen das SCLC zu einer Erkrankung mit einem hohen Bedarf an frühzeitiger palliativmedizinischer Mitbehandlung.

Schlussfolgerungen

Die frühzeitige palliativmedizinische Intervention verbessert die Lebensqualität von Krebspatienten. Zudem vermindert sie die Häufigkeit aggressiver Therapiemaßnahmen in den letzten Wochen und Tagen vor dem Tod. Durch die erhöhte Anzahl von Patientenverfügungen gelingt eine bessere Planbarkeit in krisenhaften Situationen der Erkrankung.

Abstract

Context

Small-cell lung cancer (SCLC) is an aggressive tumor with an unfavorable prognosis. There are only very limited data on the effectiveness of palliative care interventions for this disease.

Method

Selective review of the literature.

Results

Compared to other tumor types there is a more frequent and more severe symptom burden. Paraneoplastic syndromes, for instance, are seen more frequently compared to other tumor types. Given the high rate of cerebral metastases and the indications for prophylactic cranial irradiation there is a substantial risk of developing cognitive impairment. Therefore, SCLC appears to be a disease with a high need for early palliative care interventions.

Conclusions

Early palliative care can improve the quality of life of cancer patients. Furthermore it helps reduce the aggressiveness of cancer treatment near the end of life. The higher number of advance directives achieved in patients with early palliative care helps in the planning of critical situations during the course of the disease.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. M. Sebastian, D. Heigener und B. Alt-Epping geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Medizinische Klinik II, Hämatologie und Onkologie, Universitätsklinik Frankfurt, Theodor Stern-Kai 7, 60590, Frankfurt am Main, Deutschland

    M. Sebastian

  2. Abteilung Onkologie, Lungenclinic, Großhansdorf, Deutschland

    D. Heigener

  3. Klinik für Palliativmedizin, Universitätsmedizin Göttingen, Göttingen, Deutschland

    B. Alt-Epping

Authors
  1. M. Sebastian
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  2. D. Heigener
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  3. B. Alt-Epping
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Correspondence to M. Sebastian.

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Sebastian, M., Heigener, D. & Alt-Epping, B. Palliativmedizinische Aspekte beim kleinzelligen Lungenkarzinom. Onkologe 19, 962–965 (2013). https://doi.org/10.1007/s00761-013-2507-z

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  • DOI: https://doi.org/10.1007/s00761-013-2507-z

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