Thoraxtumoren pp 670-680 | Cite as

Nichtoperative Behandlung von Lungenmetastasen solider Tumoren

  • C. Manegold
  • M. Flentje


Die Lunge steht in der Metastasenentwicklung vor dem Skelett und nach der Leber an 2. Stelle (Willis 1973). Die verschiedenen Tumorerkrankungen entwikkeln unterschiedlich häufig in 20–50% der Fälle Lungenmetastasen. Die Tumor- dissemination ins Lungenparenchym erfolgt vorrangig hämatogen und/oder lymphogen (Liotta et al. 1976). 80–90% der Metastasen siedeln sich in den peripheren Lungenabschnitten oder subpleural an (Crow et al. 1981; Schölten u. Kreel 1977). Solitäre Infiltrate sind seltener als multiple Lungenmetastasen.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Azar HA, Espinoza CG, Richman AV (1982) „Undifferentiated“large cell malignancies: An ultrastructural and immunocytochemical study. Hum Pathol 12: 323–333CrossRefGoogle Scholar
  2. Beierwaltes WH, Nishiyama RH, Thompson NW, Coop JE, Kubo A (1982) Survival time and cure in papillary and follicular thyroid carcinoma with distant metastases. J Nucl Med 23: 561–568PubMedGoogle Scholar
  3. Benker G, Reiners C, Krause U, Bamberg M, Reinwein D (1988) Schilddrüsenkarzinome — aktuelle diagnostische und therapeutische Strategien. Internist 24: 564–574Google Scholar
  4. Breslow N, Churchill G, Nesmith B, Thomas PRM, Beckwith BJ, Othersen HB, d’Angio GJ (1986) Clinicopathologic features and prognosis for Wilms tumor patients with metastases at diagnosis. Cancer 58: 2501–2511PubMedCrossRefGoogle Scholar
  5. Breur K, Cohen P, Schweisguth O, Hart AMM (1978) Irradiation of the lung as an adjuvant therapy in the treatment of osteosarcoma of the limbs. Eur J Cancer 14: 461–474PubMedGoogle Scholar
  6. Brown AP, Fixsen JA, Plowman PN (1987) Local control of Ewing’s sarcoma. An analysis of 67 patients. Br J Radiol 60: 261–268PubMedCrossRefGoogle Scholar
  7. Bünemann H, Heilmann HP (1984) Tumoren der Atmungsorgane. In: Heilmann HP (Hrsg) Spezielle Strahlentherapie maligner Tumoren. Springer, Berlin Heidelberg New York Tokio (Handbuch medizinische Radiologie 14/5, S 299–451 )Google Scholar
  8. Burges JM, van Glabbecke M, Bussan A et al. (1988) Osteosarcoma of the limbs. Report of the EORTC-SIOP 03 trial 20781 investigating the value of adjuvant treatment with che-motherapy and/or prophilactic lung irradiation. Cancer 61: 1024–1031CrossRefGoogle Scholar
  9. Crow J, Slavin G, Kreel L (1981) Pulmonary metastasis: A pathologic and radiologic study. Cancer 47: 2595–2602PubMedCrossRefGoogle Scholar
  10. d’Angio GJ, Breslow N, Beckwith JB et al. (1989) Treatment of Wilms tumor. Results of the 3rd national Wilms tumor study. Cancer 64: 349–360PubMedCrossRefGoogle Scholar
  11. Didolkar MS, Fanous N, Elias EG, Moore RH (1977) Metastatic carcinomas from occult primary tumours. Ann Surg 186: 625–630PubMedCrossRefGoogle Scholar
  12. Gatter KC, Alcock C, Heryet A, Mason DY (1985) Clinical importance of analysing malignant tumours of uncertain origin with immunohistochemical techniques. Lancet 11: 1302–1305CrossRefGoogle Scholar
  13. Greco FA, Hainsworth JD (1997) Cancer of unknown primary site. In: DeVita VT Jr, Hellman S, Rosenberg SA (eds) Cancer principles and practice of oncology, 5th edn. Lippincott, Philadelphia, pp 2423–2445Google Scholar
  14. Greco FA, Vaughn WK, Hainsworth JD (1986) Advanced poorly differentiated carcinoma of unknown primary site: Recognition of a treatable syndrome. Ann Intern Med 104: 547–556PubMedGoogle Scholar
  15. Gross NJ (1981) The pathogenesis of radiation induced lung damage. Lung 159: 115–127PubMedCrossRefGoogle Scholar
  16. Hainsworth JD, Wright EP, Gray GF Jr, Greco FA (1987) Poorly differentiated carcinoma of unknown primary site: Correlation of light microscopic findings with response to cisplatin-based comoination chemotherapy. J Clin Oncol 5: 1275–1280PubMedGoogle Scholar
  17. Hainsworth JD, Wright E, Davis B, Johnson D, Greco FA (1989) Immunoperoxidase staining in the evaluation of poorly differentiated carcinoma of unknown primary site. Proc ASCO (Abstr) 8: 11Google Scholar
  18. Hales SA, Gatter KC, Heryet A, Mason DY (1989) The value of immunocytochemistry in differentiating high-grade lymphoma from other anaplastic tumours: A study of anaplastic tumours from 1940 to 1960. Leuk Lymphoma 1: 59–63CrossRefGoogle Scholar
  19. Horning SJ, Carrier EK, Rouse RV (1989) Lymphomas presenting as histologically unclassified neoplasms: Characteristics and response to treatment. J Clin Oncol 7: 1281–1287PubMedGoogle Scholar
  20. Jenkins RDT (1977) Radiation treatment of Ewing’s sarcoma and osteogenetic sarcoma. Can J Surg 20: 530–536Google Scholar
  21. Jenkins RDT, Rider WD, Sonley MJ (1976) Ewing’s sarcoma. Adjuvant total body irradiation, cyclophosphamide ana vincristine. Int J Radiat Oncol Biol Phys 1: 407–413CrossRefGoogle Scholar
  22. Jennings FL, Arden A (1962) Development of radiation pneumonitis: time and dosis factors. Arch Pathol 74: 351–358Google Scholar
  23. Jereb B, Issac R, Tournade MF et al. (1985) Survival of patients with metastases from Wilms tumor (SIOP 1, 2, 5). Eur Paediatr Haematol Oncol 2: 71–76CrossRefGoogle Scholar
  24. Kreisman H, Wolkove N (1992) Pulmonary toxicity of antineoplastic therapy. Semin Oncol 19: 508–520PubMedGoogle Scholar
  25. Lindeman GJ, Tattersall M (1995) Tumours of unknown primary site. In: Peckham M, Pinedo HM, Veronesi U (eds) Oxford textbook of oncology. Oxford Medical Publ, Oxford New York Tokio, pp 2155–2165Google Scholar
  26. Liotta LA, Kleinerman J, Saiael FM (1976) The significance of hematogenous tumor cell clumps in the metastatic process. Cancer Res 36: 889–893PubMedGoogle Scholar
  27. Manegold C, Stahel R, Mattson K et al. (on behalf of a European multinational study group) (1997) Randomized phase-II-study of Gemcitabine monotherapy vs. cisplatin plus etoposide in patients with locally advanced or metastatic non-small cell lung cancer. Proc ASCO 16: 460 a, 1651Google Scholar
  28. Nystrom JS, Weiner JM (1977) Metastatic and histologic presentations in unknown primary cancer. Semin Oncol 4: 53–58PubMedGoogle Scholar
  29. Perez CA, Tefft M, Nesbit M et al. (1981) Radiation therapy in the multimodal management of Ewing’s-sarcoma of the bone. Report of the IESS. Natl Cancer Inst Monogr 56: 263–271PubMedGoogle Scholar
  30. Rab GT, Ivins JC, Childs DS, Cupps RE, Pritchard DJ (1976) Elective whole lung irradiation in the treatment of osteogenic sarcoma. Cancer 38: 939–942PubMedCrossRefGoogle Scholar
  31. Schildt RA, Kennedv PS, Chen TT (1983) Management of patients with metastatic adenocarcinoma of unknown origin: A Southwest Oncology Group study. Cancer Treat Rep 67: 77–79Google Scholar
  32. Schölten ET, Kreel L (1977) Distribution of lung metastases in the axial plane. Radiol Clin N Am 46: 248–261Google Scholar
  33. Stea B, Kinsella TJ, Triche TJ, Horvath K, Glatstein E, Miser JS (1987) Treatment of pelvic sarcoma in adolescents and young adults with intensive combined modality therapy. Int J Radiat Oncol Biol Phys 13: 1797–1805PubMedCrossRefGoogle Scholar
  34. Twohig K, Matthay R (1990) Pulmonary effects of cytotoxic agents other than bleomycin. Clin Chest Med 11: 31–42PubMedGoogle Scholar
  35. Viettie TJ, Geban EA, Nesbit M et al. (1981) Multimodal therapy in metastatic Ewing’s-sarcoma of the bone. Report of the less. Natl Cancer Inst Monogr 56: 279–284Google Scholar
  36. Wara WM, Philipps TL, Margolis LW (1973) Radiation pneumonitis. A new approach to the derivation of time dose factors. Cancer 32: 547–552PubMedCrossRefGoogle Scholar
  37. Willis RA (1973) Secondary tumors of the lung. The spread of tumors in the human body. Butter worth, London, pp 167–174Google Scholar

Copyright information

© Springer Verlag Berlin Heidelberg 1998

Authors and Affiliations

  • C. Manegold
  • M. Flentje

There are no affiliations available

Personalised recommendations