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Die Chemotherapie der nicht-kleinzelligen Bronchuskarzinome

  • R. A. Joss
  • K. W. Brunner
Conference paper

Zusammenfassung

Die malignen Tumoren der Lunge stellen ein erstrangiges, bisher ungelöstes Problem der Krebsbekämpfung dar. Die Häufigkeit der Bronchuskarzinome nimmt in allen westlichen Ländern weiterhin zu und die rasch ansteigende Inzidenz bei Frauen ist besonders alarmierend. Rund drei Viertel aller bösartigen Lungenge-schwülste werden den nicht-kleinzelligen Bronchuskarzinomen zugeordnet. Unter diesem sprachlich nicht sehr glücklichen Sammelbegriff werden das Platten-epithel-, das Adeno- und das anaplastische großzellige Karzinom der Lunge zusammengefaßt. Da die präoperativen Abklärungen und gegebenenfalls die chirurgisch-pathologischen Befunde zeigen, daß nur rund ein Viertel aller Patienten mit diesen histologischen Formen der Lungenkarzinome radikal reseziert werden kann und langfristig lediglich 10% aller Patienten mit einer Operation und/oder einer Strahlentherapie geheilt werden, ist die Suche nach einer wirksamen Chemotherapie ein vordringliches Problem der internistischen Onkologie [36]. In den nachfolgenden Ausführungen sollen deshalb die zytostatischen Behandlungs-möglichkeiten der nicht-kleinzelligen Bronchuskarzinome eingehend besprochen werden, währenddem auf die chirurgischen und radiotherapeutischen Aspekte nur kurz im Zusammenhang mit der multimodalen Behandlung eingegangen wird. Für eine weitergehende Diskussion der operativen und radiotherapeutischen Belange sei auf mehrere, kürzlich publizierte, zum Teil ausführliche Über-sichtsarbeiten verwiesen [39, 58, 61, 63, 78].

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Literatur

  1. 1.
    Aisner J, Hansen HH (1981) Commentary: Current status of chemotherapy for non-small cell lung cancer. Cancer Treat Rep 65: 979–986PubMedGoogle Scholar
  2. 2.
    Anderson P, Spain R, Speer J (1984) Mitomycin-C (M), Cis-Platinum (P) and Vinblastine (V) infusion (M-PV) in combined modality therapy (CMT) of Stage III non-small cell lung cancer (NSCLC). Proc Am Soc Clin Oncol 3: 217Google Scholar
  3. 3.
    Beretta G, Clerici M, Labianca R et al. (1981) CAMP polychemotherapy in locally advanced unresectable and/or metastatic non-small cell carcinoma of the lung. Abstracts, UICC Conference on Clinical Oncology, Lausanne, Switzerland, p 20Google Scholar
  4. 4.
    Bitran JD, Desser RK, DeMeester T et al. (1978) Metastatic non-oat cell bronchogenic carcinoma: therapy with cyclophosphamide, doxorubicin, methotrexate and procarbazine (CAMP). J Am Med Assoc 240: 2743–2746CrossRefGoogle Scholar
  5. 5.
    Bodey GP, Lagakos SW, Gutierrez AC (1977) Therapy of advanced squamous carcinoma of the lung. Cyclophosphamide versus “COMB”. Cancer 39: 1026–1031PubMedCrossRefGoogle Scholar
  6. 6.
    Brindley CO, Liu FH, Lu JP (1981) Treatment of non-small cell carcinoma of the bronchus (NSCCB) with cyclophosphamide, adriamycin and cis-platinum. Proc Am Soc Clin Oncol 22: 496Google Scholar
  7. 7.
    Britell JC, Eagan RT, Ingle JN (1978) Cis-Dichlorodiammineplatinum(II) alone followed by adriamycin plus cyclophosphamide at progression versus cis-dichlorodiammine-platinum (II), adriamycin, and cyclophosphamide in combination for adenocarcinoma of the lung. Cancer Treat Rep 63: 2107–2109Google Scholar
  8. 8.
    Brunner KW, Joss R, Goldhirsch A (1983) Der Stand der Chemotherapie beim inoperablen nicht-kleinzelligen Bronchuskarzinom. Schweiz Rundschau Med 72: 1057–1062Google Scholar
  9. 9.
    Brunner KW, Veraguth P, Obrecht JP et al. (1978) Radio- or chemotherapy or combined treatment in inoperable locoregional lung cancer. Proc Am Soc Clin Oncol 19:C-436Google Scholar
  10. 10.
    Casper ES, Gralla RJ, Kelsen DP (1982) Complete responses of non-small cell lung carcinoma to combination chemotherapy. Abstract 270, The I II World Conference on Lung Cancer, TokyoGoogle Scholar
  11. 11.
    Chahinian AP, Mandel EM, Holland JF et al. (1979) MACC (methotrexate, adriamycin, cyclophosphamide and CCNU) in advanced lung cancer. Cancer 43: 1590–1597PubMedCrossRefGoogle Scholar
  12. 12.
    Cohen MH, Perevodchikova NI (1979) Single agent chemotherapy of lung cancer. In: Rozencweig M (eds) Lung cancer: Progress in therapeutic research. Muggia F, Raven Press, New York, pp 343–374Google Scholar
  13. 13.
    Cormier Y, Bergeron D, La Forge J et al. (1982) Benefits of polychemotherapy in advanced non-small cell bronchogenic carcinoma. Cancer 50: 845–849PubMedCrossRefGoogle Scholar
  14. 14.
    Davis S, Rambotti P, Park YK (1981) Combination cyclophosphamide, doxorubicin, and cis-Platin (CAP) chemotherapy for extensive non-small cell carcinomas of the lung. Cancer Treat Rep 64: 955–958Google Scholar
  15. 15.
    De Vogelaere R (1984) Persdnliche MitteilungGoogle Scholar
  16. 16.
    DeWys WD, Begg C, Lavin PT (1980) Prognostic effect of weight loss prior to chemotherapy in cancer patients. Am J Med 69: 491–497PubMedCrossRefGoogle Scholar
  17. 17.
    Dhingra HM, Valdivieso M, Booser DJ (1984) Chemotherapy for advanced adenocarcinoma and squamous cell carcinoma of the lung with etoposide and Cisplatin. Cancer Treat Rep 68: 671–673PubMedGoogle Scholar
  18. 18.
    Dhingra HM, Murphy WK, Chiuten DF (1984) Chemotherapy with cisplatin (DDP) with vindesine (YDS) and/or VP 16 for advanced adeno squamous cell lung cancer and its effect on P. S. (ECOG) of patients. Proc Am Soc Clin Oncol 3: 220Google Scholar
  19. 19.
    Eagan RT, Frytak S, Creagan ET et al. (1979) Phase II study of cyclophosphamide, adriamycin, and cis-dichlorodiammineplatinum(II) by infusion in patients with adenocarcinoma and large cell carcinoma of the lung. Cancer Treat Rep 63: 1589–1591PubMedGoogle Scholar
  20. 20.
    Eagan RT, Ingle JV, Frytak S (1977) Platinum based polychemotherapy versus dianhydro-galactitol in advanced non-small cell lung cancer. Cancer Treat Rep 61: 1339–1415PubMedGoogle Scholar
  21. 21.
    Eagan RT, Lee RE, Frytak S (1979) Randomized trial of thoracic irradiation plus combination chemotherapy for unresectable adenocarcinoma and large cell carcinoma of the lung. Int J Radiat Oncol Biol Phys 5: 1401–1405PubMedGoogle Scholar
  22. 22.
    Edmonson JH, Lagakos SW, Selawry OS et al. (1976) Cyclophosphamide and CCNU in the treatment of inoperable small cell carcinoma and adenocarcinoma of the lung. Cancer Treat Rep 60: 925–932PubMedGoogle Scholar
  23. 23.
    Elliott JA, Ahmedzai S, Hole D (1983) Superiority of vindesine (VDS) plus Cis-Platinum (DDP) over VDS alone for non-small cell lung cancer (NSCLC). Abstract 10-14, 2nd European Conference on Clinical Oncology and Cancer Nursing, AmsterdamGoogle Scholar
  24. 24.
    Evans WK, Feld R, De Boer G et al. (1981) Cyclophosphamide, doxorubicin, and cisplatin in the treatment of non-small cell bronchogenic carcinoma. Cancer Treat Rep 65: 947–954PubMedGoogle Scholar
  25. 25.
    Folman R, Rosman M, Auerbach S (1984) Mitomycin-C, Vinblastine, and Cis-Platinum (MVP) in the combined modality treatment of non-small cell lung cancer (NSCLC). Proc Amer Soc Clin Oncol 3: 232Google Scholar
  26. 26.
    Fuks JZ, Egorin M J, Aisner J (1983) Therapeutic efficacy and pharmacokinetics of vindesine and vindesine-cisplatin in previously treated patients with nonsmall cell lung carcinoma. Cancer Chemother Pharmacol 10: 104–108PubMedCrossRefGoogle Scholar
  27. 27.
    Gralla RJ, Cvitkovic E, Golbey RB (1979) Cis-dichlorodiammineplatinum(II) in non-small cell carcinoma of the lung. Cancer Treat Rep 63: 1585–1588PubMedGoogle Scholar
  28. 28.
    Gralla RJ, Casper ES, Kelsen DP (1981) Cisplatin and Vindesine combination chemotherapy for advanced carcinoma of the lung: a randomized trial investigating two dosage schedules. Ann Intern Med 95: 414–420PubMedGoogle Scholar
  29. 29.
    Green RA, Humphrey E, Close H (1969) Alkylating agents in bronchogenic carcinoma. Am J Med 46: 516–525PubMedCrossRefGoogle Scholar
  30. 30.
    Griffin JP, Niell HB (1984) Mitomycin, Vinblastine and Cisplatin in the treatment of Stage III non-small cell lung cancer. Proc Am Soc Clin Oncol 3: 211Google Scholar
  31. 31.
    Holmes EC, Eagan RT, and the Lung Cancer Study Group (1984) Surgical adjuvant therapy of resectable stage II/III adenocarcinoma and large cell undifferentiated carcinoma of the lung. Proc Am Soc Clin Oncol 3: 220Google Scholar
  32. 32.
    Israël L, Clavier J, David Ph (1984) Preoperative cisplatinum and bleomycin in 53 squamous cell carcinomas of the lung. Proc Am Soc Clin Oncol 3: 213Google Scholar
  33. 33.
    Joss RA, Alberto P, Obrecht JP (1984) Combination chemotherapy of non-small cell lung cancer with adriamycin and mitomycin-C or cisplatin and etoposide. Cancer Treat Rep 68: 1079–1084PubMedGoogle Scholar
  34. 34.
    Joss R, Bleher EA, Goldhirsch A et al. (1983) Adjuvante Therapien beim operablen nicht-kleinzelligen Bronchuskarzinom. Schweiz Rundsch Med 72: 553–560Google Scholar
  35. 35.
    Joss RA, Cavalli F, Goldhirsch A (1985) New agents in non-small cell lung cancer. Cancer Treat Rev (in press)Google Scholar
  36. 36.
    Joss R, Goldhirsch A, Brunner K (1980) „Das anaplastische kleinzellige Bronchuskarzi-nom” und „Das nicht-kleinzellige Bronchuskarzinom”. Deutsch Med Wochenschr 105:732–735; 105: 766–770Google Scholar
  37. 37.
    Joss R, Goldhirsch A, Cavalli F et al. (1981) Chemotherapie des nicht-kleinzelligen Bron- chuskarzinoms mit einer Kombination von Cis-Diamminedichloroplatinum(II) und VP 16-213. Schweiz Med Wochenschr 111: 1331–1334PubMedGoogle Scholar
  38. 38.
    Joss R, Castiglione M, Goldhirsch A (1984) Mitomycin (MMC), Vindesine (VOS) and Cisplatin (DDP) in the treatment of non-small cell lung cancer - a pilot study for the Swiss group for Clinical Cances Research (SANK). Abstract 141, loth Annual Meeting of the European Society for Medical Oncology, Nice 1984Google Scholar
  39. 39.
    Kjaer M (1982) Radiotherapy of squamous-, adeno- and large cell carcinoma of the lung. Cancer Treat Rev 9: 1–20PubMedCrossRefGoogle Scholar
  40. 40.
    Klastersky J, Dumont JP, Sculier JP (1984) Comparative study of two dosages of Cisplatin (120 mg/m2 and 60 mg/m2) in combination with etoposide for the treatment of non-small cell lung cancer (NSCLC). Proc Am Soc Clin Oncol 3: 211Google Scholar
  41. 41.
    Knost JA, Greco FA, Hande KR et al. (1981) Cyclophosphamide, doxorubicin, and cisplatin in the treatment of advanced non-small cell lung cancer. Cancer Treat Rep 65: 941–945PubMedGoogle Scholar
  42. 42.
    Kris MG, Gralla RJ, Kelsen DP (1984) Trials adding mitomycin to vindesine and to vindesine plus cisplatin in non-small cell lung cancer. Proc Am Soc Clin Oncol 3: 225Google Scholar
  43. 43.
    Krook JE, Fleming TR, Eagan RT (1984) Comparison of combination chemotherapy programs in advanced adenocarcinoma - large cell carcinoma of the lung: a north central cancer treatment Group study. Cancer Treat Rep 68: 493–498PubMedGoogle Scholar
  44. 44.
    Lad T, Sarma PR, Diekamp U et al. (1979) CAMP combination chemotherapy for unresectable non-oat cell bronchogenic carcinoma. Cancer Clin Trials 2: 321–326PubMedGoogle Scholar
  45. 45.
    Lad TE, Nelson RB, Diekamp U et al. (1981) Immediate versus postponed combination che-motherapy (CAMP) for unresectable non-small cell lung cancer: a randomized trial. Cancer Treat Rep 65: 973–978PubMedGoogle Scholar
  46. 46.
    Legha SS, Muggia FM, Carter SK (1977) Adjuvant chemotherapy in lung cancer. Review and Prospects. Cancer 39: 1415–1424PubMedCrossRefGoogle Scholar
  47. 47.
    Livingston RB (1979) Combined modality therapy for non-small cell carcinoma of the lung. In: Jones SE, Salmon SE (eds): Adjuvant therapy of Cancer I I. Grune and Stratton, New YorkGoogle Scholar
  48. 48.
    Livingston RB, Fee WH, Einhorn LH et al. (1976) BACON (Bleomycin, Adriamycin, CCNU, Oncovin, Nitrogen Mustard) in squamous lung cancer. Cancer 37: 1237–1242PubMedCrossRefGoogle Scholar
  49. 49.
    Livingston RB, Heilbrun L, Lehane D et al. (1977) Comparative trial of combination chemotherapy in extensive squamous carcinoma of the lung: a Southwest Oncology Group Study. Cancer Treat Rep 61: 1623–1629PubMedGoogle Scholar
  50. 50.
    Livingston RB, Heilbrun LH (1978) Patterns of response and relapse in chemotherapy of extensive squamous carcinoma of the lung. Cancer Chemother Pharmacol 1: 225–227PubMedCrossRefGoogle Scholar
  51. 51.
    Longeval E, Klastersky J (1982) Combination chemotherapy with Cisplatin and Etoposide in bronchogenic squamous cell carcinoma and adenocarcinoma. Cancer 50: 2751–2756PubMedCrossRefGoogle Scholar
  52. 52.
    Madej PJ, Bitran JD, Colomb HM (1984) Combined modality therapy for stage III M0 non-small cell lung cancer. A five year experience. Cancer 54: 5–12PubMedCrossRefGoogle Scholar
  53. 53.
    Mason BA, Catalano RB (1980) Mitomycin, vinblastine and cisplatin combination chemo-therapy in non-small cell lung cancer. Proc Am Soc Clin Oncol 21: 447Google Scholar
  54. 54.
    Miller TP, Chen TT (1983) Alternating combination chemotherapy prolongs survival for metastatic non-small cell lung cancer. Proc Am Soc Clin Oncol 2: 188Google Scholar
  55. 55.
    Miller TP, McMahon LJ, Livingston RB (1980) Extensive adenocarcinoma and large cell undifferentiated carcinoma of the lung treated with 5-FU, Vincristine and Mitomycin C (FOMi). Cancer Treat Rep 64: 1241–1245Google Scholar
  56. 56.
    Miller TP, Vance RB, Tong TC (1984) Treatment of advanced non-small cell lung cancer (NSCLC) with mitomycin-C + cisplatin + Vindesine (MiPE): comparison to other Mito-mycin C + Vinca-containing combinations (For the Southwest Oncology Group). Proc Am Soc Clin Oncol 3: 230Google Scholar
  57. 57.
    Milstein D, Robinson E (1981) Four-drug combination chemotherapy in advanced lung cancer: methotrexate, doxorubicin, cyclophosphamide and CCNU. Cancer 48: 2358–2363PubMedCrossRefGoogle Scholar
  58. 58.
    Minna JD, Higgins GA, Glatstein EJ (1982) Cancer of the lung. In: DeVita VT, Hellmann S, Rosenberg SA (eds) Cancer. Principles and practice of oncology. J. B. Lippincott Company, Philadelphia TorontoGoogle Scholar
  59. 59.
    Mitrou PS, Graubner M, Berdel WE (1984) cis-Platinum (DDP) and VP 16-213 (etoposide) combination chemotherapy for advanced non-small cell lung cancer. A phase II clinical trial. Eur J Cancer Clin Oncol 20: 347–351Google Scholar
  60. 60.
    Mountain CF (1980) Surgery of lung cancer including adjunctive therapy. In: Hansen HH, Rorth M (eds) Excerpta Medica, Amsterdam Oxford PrincetonGoogle Scholar
  61. 61.
    Mountain CF (1983) Biologic, physiologic, and technical determinants in surgical therapy for lung cancer. In: Straus MJ (ed) Lung cancer. Clinical Diagnosis and Treatment. Second Edition. Grune and Stratton, New YorkGoogle Scholar
  62. 62.
    Muggia FM, Blum RH, Foreman JD (1984) Role of chemotherapy in the treatment of lung cancer: evolving strategies for non-small cell histologies. Int J Radiat Oncol Biol Phys 10: 137–145PubMedGoogle Scholar
  63. 63.
    Nachbur B (1983) Neuere Aspekte in der Chirurgie des Bronchialkarzinoms. Schweiz Rundsch Med 72: 437–441Google Scholar
  64. 64.
    Perez CA, Stanley K, Rubin P (1980) A prospective randomized study of various irradiation doses and fractionation schedules in the treatment of inoperable non-oat cell carcinoma of the lung: preliminary report by the Radiation Therapy Oncology Group. Cancer 45: 2744–2753PubMedCrossRefGoogle Scholar
  65. 65.
    Reimer RR, Gahbauer R, Bukowski RM (1981) Simultaneous treatment with cisplatin and radiation therapy for advanced solid tumors: a pilot study. Cancer Treat Rep 65: 219–222PubMedGoogle Scholar
  66. 66.
    Reynolds RD, Pajak TF, Bateman JR (1979) Considerations in designing and analyzing surgical adjuvant study in resected stage I and II carcinoma of the lung. Cancer 44: 1201–1210PubMedCrossRefGoogle Scholar
  67. 67.
    Robert F, Omura GA, Birch R (1984) Randomized phase III comparison of three doxorubicin-based chemotherapy regimens in advanced non-small cell lung cancer: a Southeastern Cancer Study Group Trial. J Clin Oncol 2: 391–395PubMedGoogle Scholar
  68. 68.
    Ruckdeschel JC, Mason B, Ettinger D (1982) Chemotherapy of metastatic non-oat cell bron-chogenic carcinoma. The Eastern Cooperative Oncology Group Experience. Abstract 265, I II World Conference on Lung Cancer, TokyoGoogle Scholar
  69. 69.
    Ruckdeschel JC, Mehta CR, Salazar OM (1981) Chemotherapy for metastatic non-small cell bronchogenic carcinoma: EST 2575, Generation III, HAM versus CAMP. Cancer Treat Rep 65: 959–963PubMedGoogle Scholar
  70. 70.
    Ruckdeschel JC, Mehta CR, Salazar OM (1981) Chemotherapy for inoperable non-small cell bronchogenic carcinoma: EST 2575. Generation II. Cancer Treat Rep 65: 965–972PubMedGoogle Scholar
  71. 71.
    Schectman G, Camacho FJ, Vogl SE (1984) A phase II study of vindesine(V) infusion and cis-platinum (DDP) in advanced non-small cell lung cancer (NSCLC). Proc Am Soc Clin Oncol 3: 217Google Scholar
  72. 72.
    Schulman P, Budman DR, Weiselberg L (1983) Phase II trial of mitomycin, vinblastine, and cisplatin (MVP) in non-small cell bronchogenic carcinoma. Cancer Treat Rep 67: 943–945PubMedGoogle Scholar
  73. 73.
    Sealy R (1979) Combined radiotherapy and chemotherapy in non-small cell carcinoma of the lung. In: Muggia FM, Rozencweig M (eds) Lung Cancer: Progress in therapeutic research. Raven Press, New YorkGoogle Scholar
  74. 74.
    Selawry OS (1974) The role of chemotherapy in the treatment of lung cancer. Semin Oncol 1: 259–272PubMedGoogle Scholar
  75. 75.
    Shields TW (1981) Natural history of patients after resection of a bronchial carcinoma. Surg Clin North Am 61: 1279–1294PubMedGoogle Scholar
  76. 76.
    Stanley KE (1980) Prognostic factors for survival in patients with inoperable lung cancer. J Natl Cancer Inst 65: 25–32PubMedGoogle Scholar
  77. 77.
    Trybula M, Taylor SG, Bonomi P (1984) Preoperative simultaneous cisplatin/5-Fluorouracil and radiotherapy in clinical stage III, non-small cell bronchogenic carcinoma. Proc Am Soc Clin Oncol 3: 223Google Scholar
  78. 78.
    Yeraguth P (1983) Wann sollen Bronchuskarzinome bestrahlt werden? Schweiz Rundsch Med 72: 442–447Google Scholar
  79. 79.
    Veronesi A, Zagonel V, Santarossa M (1983) cis-Platinum and Etoposide combination chemotherapy of advanced non-oat cell bronchogenic carcinoma. Cancer Chemother Pharmacol 11: 35–37Google Scholar
  80. 80.
    Vogelzang NJ, Bonomi PD, Rossoff AH et al. (1978) Cyclophosphamide, adriamycin, methotrexate and procarbazine (CAMP) treatment of non-oat cell bronchogenic carcinoma. Cancer Treat Rep 62: 1595–1597PubMedGoogle Scholar
  81. 81.
    Vogl SE, Mehta CR, Cohen MH (1979) MACC chemotherapy for adenocarcinoma and epidermoid carcinoma of the lung. Cancer 44: 864–868PubMedCrossRefGoogle Scholar
  82. 82.
    World Health Organization (1979) WHO Handbook for Reporting Results of Cancer Treatment. GenevaGoogle Scholar
  83. 83.
    Wolf J, Hyde L, Phillips RW (1979) Recent comparative trials of systemic therapy in non-small cell carcinoma of the lung. In: Muggia FM, Rozencweig M (eds) Lung cancer. Progress in therapeutic research. Raven Press, New YorkGoogle Scholar
  84. 84.
    Wolf J, Spear P, Yesner R et al. (1960) Nitrogen mustard and the steroid hormones in the treatment of inoperable bronchogenic carcinoma. Am J med 29: 1008–1016PubMedCrossRefGoogle Scholar

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© Springer-Verlag Berlin Heidelberg 1985

Authors and Affiliations

  • R. A. Joss
  • K. W. Brunner

There are no affiliations available

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