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Die Rolle der Strahlentherapie in der Behandlung des kleinzelligen Bronchialkarzinoms

  • W. Alberti
Conference paper
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Zusammenfassung

Lange Zeit war die Radiotherapie bei Inoperabilität die wichtigste Behandlungs-methode für das kleinzellige anaplastische Bronchialkarzinom. Allerdings war diese meist auf die palliative Anwendung bei Auftreten von Metastasen oder zur Besserung der Symptome der lokoregionalen Erkrankung beschränkt. Seit der Einführung einer effektiveren systemischen Chemotherapie zu Beginn der 70er Jahre hat sich die mediane Überlebenszeit dieser Patienten mit limitierter Erkrankung von 5–6 Monaten mit Strahlentherapie allein gegenüber 10–14 Monaten mit Chemo- und Strahlentherapie (Choi u. Carey, 1976; Livingston et al., 1978; Greco et al., 1979; Sierocki et al., 1980) oder Chemotherapie allein (Aisner u. Wiernek, 1980) deutlich verbessert. Durch diese günstigen Resultate wurde die traditionelle Rolle der Radiotherapie als Teil eines potentiell kurativen Behandlungskonzeptes in Frage gestellt. Trotz der optimistischen Einstellung gegenüber einer Kombinationschemotherapie, die auf Kurzzeit-Erfahrungen basierte, scheint ein Plateau in der Überlebenszeit erreicht zu sein (Salazar u. Creech, 1980; Cohen, 1980; Niederle, 1985). Der Grund liegt in einer hohen Rezidivrate, wobei dem lokalen und regionalen Rezidiv besondere Bedeutung zukommt (Bleehen, 1979; Niederle et al., 1982).

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© Springer-Verlag Berlin Heidelberg 1985

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  • W. Alberti

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