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Aktuelle medikamentöse Therapie des Bronchialkarzinoms

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Verhandlungen der Deutschen Gesellschaft für Innere Medizin

Part of the book series: Verhandlungen der Deutschen Gesellschaft für Innere Medizin ((VDGINNERE,volume 96))

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Zusammenfassung

Die Entscheidung zur Therapie wird bei einem an einem Bronchialkarzinom erkrankten Patienten hauptsächlich von seinem Leistungsindex sowie vom histologischen Typ und Ausbreitungsstadium des Tumors bestimmt. Obwohl nach der Klassifikation der Weltgesundheitsorganisation 95% alle Lungentumoren den 4 Kategorien Plattenepi-thelkarzinom, Adenokarzinom, großzelliges Karzinom und kleinzelliges Karzinom zugeordnet werden können, ist für die Klinik eine vereinfachte Einteilung in 2 Gruppen möglich. Sie basiert auf der Empfindlichkeit des Tumors gegenüber der Chemotherapie. Somit unterscheidet man die Gruppe der kleinzelligen Karzinome, die ca. 20% aller Patienten einschließt, von der größeren heterogenen Gruppe der nichtkleinzelligen Karzinome. Die kleinzelligen Karzinome unterscheiden sich nicht nur im Hinblick auf die Sensibilität gegenüber der Chemotherapie und der Radiotherapie von den nichtkleinzelligen Karzinomen, sondern sie weisen grundsätzlich andere biologische Eigenschaften auf [14]. Diese Tumoren proliferieren wesentlich rascher und metastasieren früher regionär und systemisch. Durch die Auswertung mehrerer klinischer Studien konnten in den vergangenen Jahren krankheits- und patientenbezogene prognostische Faktoren identifiziert werden [74]. Es ist möglich, daß sie den weiteren Krankheitsverlauf stärker beeinflussen, als das gewählte Therapieverfahren [2]. Unter den prognostischen Faktoren führen der Aktivitätsindex des Patienten und das Tumorstadium, also die Tumormasse. Weitere prognostische Faktoren, die sowohl die Remissionsraten als auch die Überlebensdauern der Patienten bestimmen können, sind ein Gewichtsverlust von mehr als 10%, die Aktivität der Laktatdehydrogenase, histologische Subtypen des Tumors und das Geschlecht des Patienten.

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Literatur

  1. Aaronson NK, Bullinger M, Ahmedzai S (1988) A modular approach to quality-of-life assessment in cancer clinical trials. Recent Results Cancer Res 111:231–249.

    Article  PubMed  CAS  Google Scholar 

  2. Aisner J, Hansen HH (1981) Current status of chemotherapy for non-small cell lung cancer (commentary). Cancer Treat Rep 65:979–986.

    PubMed  CAS  Google Scholar 

  3. Aisner J, Whitcare M, Echo DA van, Wiernik PH (1982) Combination chemotherapy for small cell carcinoma of the lung: continous vs. alternating non-cross resistant combinations. Cancer Treat Rep 66:221–230.

    PubMed  CAS  Google Scholar 

  4. Aisner J, Alberto P, Bitran J, Comis R, Daniels J, Hansen HH, Smyth J (1983) Role of chemotherapy in small cell lung cancer: a consensus report of the International Association for the Study of Lung Cancer Workshop. Cancer Treat Rep 67:37–43.

    PubMed  CAS  Google Scholar 

  5. Arriagada R, Pignon JP, Le Chevalier T (1989) Thoracic radiotherapy in small cell lung cancer: rationale for timing and fractionation. Lung Cancer 5:237–247.

    Article  Google Scholar 

  6. Ayoub J, Duranceau A, Lorange G, et al. and participating RICUM investigators (1987) Effectiveness of adjuvant chemotherapy in operable non-small cell lung cancer (NSCLC). In: Salmon SE (ed) Adjuvant therapy of cancer, vol. V. Grune & Stratton, Orlando San Diego New York London San Francisco Tokyo Sydney Toronto, pp 157–164.

    Google Scholar 

  7. Bakowski MT, Crouch JC (1983) Chemotherapy for non-small cell lung cancer. A reappraisal and a look to the future. Cancer Treat Rep 10:159–172.

    Article  CAS  Google Scholar 

  8. Bleehen NM, Bunn PA, Cox JD, et al. (1983) Role of radiation therapy in small cell anaplastic carcinoma of the lung. Cancer Treat Rep 67:11–19.

    PubMed  CAS  Google Scholar 

  9. Bonomi P (1986) Brief overview of combination chemotherapy in non-small-cell lung cancer. Semin Oncol 13:89–91.

    PubMed  CAS  Google Scholar 

  10. Bunn A (1986) Recent advances in the biology and treatment of small-cell lung cancer. Adv Oncol 2:9–15.

    Google Scholar 

  11. Bunn PA (1985) Vepesid: it’s role in small cell lung cancer. Myers, Syracuse/NY Bristol, pp 1-53.

    Google Scholar 

  12. Bunn PA, Ihde DC (1981) Small cell bronchogenic carcinoma. A review of therapeutic results. In: Livingston RB (ed) Lung cancer, vol. I. Nijhoff, The Hague, pp 169–208.

    Google Scholar 

  13. Bunn PA, Cullen M, Fukuoka M, et al. (1989) Chemotherapy in small cell lung cancer: a consensus report. Lung Cancer 5:127–134.

    Article  Google Scholar 

  14. Carney DN, Broder L, Edelsstein M, et al. (1983) Experimental studies of the biology of human small cell lung cancer. Cancer Treat Rep 67:27–35.

    PubMed  CAS  Google Scholar 

  15. Cormier YD, Bergeron J, La Forge, Lavandrier M, Foernier M, Chenard J, Desmeules M (1982) Benefits of polychemotherapy in advanced non smal cell bronchogenis carcinoma. Cancer 50:845–849.

    Article  PubMed  CAS  Google Scholar 

  16. Cullen MM, Joshi R, Chetiyawardana AD, Woodroffe CM (1988) Mitomycine, ifosfamide and cisplatin in non-small cell lung cancer. Treatment good enough to compare. Br J Cancer 58:359–361.

    Article  PubMed  CAS  Google Scholar 

  17. Drings P (1988) Neoadjuvante Chemotherapie des nicht-kleinzelligen Bronchialkarzinoms. In: Hermann R, Schlag P (Hrsg) Neoadjuvante Chemotherapie maligner Tumoren. Thieme, Stuttgart New York, S 46–52.

    Google Scholar 

  18. Drings P, Bülzebruck H, Hruska D, Manke HG, Schuler G (1986) EPICO für die Behandlung des kleinzelligen Bronchialkarzinoms, 3. Zwischenanalyse. Onkologie 9:14–20.

    Article  Google Scholar 

  19. Drings P, Becker H, Bülzebruck H, Djawid N, Ruchall E, Stiefel P, Tessen HW (1988) Die Chemotherapie des nicht kleinzelligen Bronchialkarzinoms mit Ifosfamid in Kombination mit Cisplatin, Etoposid oder Vindesin. Onkologie 11:47–56.

    Article  PubMed  Google Scholar 

  20. Eagan RT, Frytak S, Creagan ET, et al. (1979) Phase II-study of cyclophosphamide, adria-mycin, and cisdichlorodiamine-platinum (II) by infusion in patients with adenocarcinoma and large cell carcinoma of the lung. Cancer Treat Rep 63:1589.

    PubMed  CAS  Google Scholar 

  21. Elliot JA (1986) Is there standard chemotherapy for non-small cell lung cancer? Eur J Cancer Clin Oncol 22:269–371.

    Article  Google Scholar 

  22. Feld R, Evans WK, DeBoer G, et al. (1984) Combined modality induction therapy without maintenance chemotherapy for small cell carcinoma of the lung. J Clin Oncol 2:294–304.

    PubMed  CAS  Google Scholar 

  23. Feld P, Rubinstein LV, Weisenberger TH (1984) Lung Cancer Study Group: Sites of recurrences in resected stage I non-small cell lung cancer: a guide for future studies. J Clin Oncol 2:1352–1358.

    PubMed  CAS  Google Scholar 

  24. Feld R, Ginsberg J, Payne DG (1989) Treatment of small cell lung cancer. In: Roth JA, Ruckdeschel JC, Weisenburger TH (eds) Thoracic oncology. Saunders, Philadelphia, pp 229–262.

    Google Scholar 

  25. Folman RS, Rosman M (1988) The role of chemotherapy in non-small cell lung cancer: the community perspective. Semin Oncol 15:16–21.

    PubMed  CAS  Google Scholar 

  26. Ganz PA, Figlin RA, Haskell CM, La Soto N, Siau J (1989) Supportive care versus supportive care and combination chemotherapy in metastatic non-small cell lung cancer. Cancer 63:1271–1278.

    Article  PubMed  CAS  Google Scholar 

  27. Gralla RJ, Casper ES, Kelsen DP (1981) Cisplatin and vindesine combination chemotherapy for advanced carcinoma of the lung: a randomized trial investigating two dosage scheduls. Ann Intern Med 95:414–420.

    PubMed  CAS  Google Scholar 

  28. Greco A (1986) Rationale for chemotherapy for patients with advanced non-small cell lung cancer. Semin Oncol 13:92–96.

    PubMed  CAS  Google Scholar 

  29. Greco FA, Oldham RK (1981) Clinical management of patients with small cell lung cancer. In: Greco FA, Oldham RK, Bunn PA (eds) Small cell lung cancer. Grune & Stratton, New York, pp 353–379.

    Google Scholar 

  30. Greco FA, Johnson DH, Hainsworth JD, Wolff StN (1985) Chemotherapy of small cell lung cancer. Semin Oncol 12:31–37.

    PubMed  CAS  Google Scholar 

  31. Harms V, Havemann K, Drings P, et al. (1983) A randomized multicenter trial comparing sequential versus alternating polychemotherapy in small cell lung cancer. Proceedings of the 13th International Congress of Chemotherapy, pp 248/10-248/14.

    Google Scholar 

  32. Harper PG, Souhami RL (1985) Intensive chemotherapy with autologous bone marrow transplantation in small cell carcinoma of the lung. Recent Results Cancer Res 97:146–156.

    Article  PubMed  CAS  Google Scholar 

  33. Havemann K, Wolf M, Holle R, et al. (1987) Alternating versus sequentiell chemotherapy in small cell lung cancer. Cancer 59:1072–1082.

    Article  PubMed  CAS  Google Scholar 

  34. Hofmann PC, Weimann DS, Bitran JD, DeMeester TR, Golom HM, Cimochowski GE, Skosey C (1982) Surgical resection in patients with stage III Mo small cell lung carcinoma of the lung. Proc Am Soc Clin Oncol 1:147 (abstract C571).

    Google Scholar 

  35. Hyde L, Yee J, Wilson R, Patno ME (1965) Cell type and the natural history of lung cancer. JAMA 193:140–142.

    Article  Google Scholar 

  36. Hyde L, Wolf J, McCracke S, Yesner R (1973) Natural course of inoperable lung cancer. Chest 64:309–312.

    Article  PubMed  CAS  Google Scholar 

  37. Ihde DD (1986) Neo-adjuvant chemotherapy of lung cancer, preliminary North-American experience. Neoadjuvant chemotherapy. Coll. INSERM/ John Libbey Eurotext 137:467–472.

    Google Scholar 

  38. Johnson RE, Brereton HD, Kent CH (1976) Small cell carcinoma of the lung. Attempt to remedy causes of past therapeutic failure. Lancet I:289.

    Article  Google Scholar 

  39. Johnson RR, Bereton HD, Kent CH (1978) „Total“therapy for small cell carcinoma of the lung. Ann Thorac Surg 25:570–575.

    Article  Google Scholar 

  40. Joss PA, Brunner KW (1985) Die Chemotherapy der nicht kleinzelligen Bronchialkarzinome. In: Seeber S, Niederle S (Hrsg) Interdisziplinäre Therapie des Bronchialkarzinoms. Springer, Berlin Heidelberg New York Tokyo, S 75–94.

    Chapter  Google Scholar 

  41. Kaasa St, Mastekaase A, Stokke I, Naess S (1988) Validation of a quality of life questionnaire for use in clinical trials for treatment of patients with inoperable lung cancer. Eur J Cancer Clin Oncol 24:691–701.

    Article  PubMed  CAS  Google Scholar 

  42. Kenis Y (1980) Surgical adjuvant chemotherapy in non-small cell carcinoma of the lung. Int J Radiat Oncol Biol Phys 6:1075–1077.

    Article  PubMed  CAS  Google Scholar 

  43. Klastersky J, Sculier JP (1985) Chemotherapy of non-small-cell lung cancer. Semin Oncol 12:38–48.

    PubMed  CAS  Google Scholar 

  44. Klastersky J, Sculier JP (1989) Intensive chemotherapy of small cell lung cancer. Lung Cancer 5:196–296.

    Article  Google Scholar 

  45. Klippstein Th, Graubner M, Berdek WE, Mende E, Gropp C, Mitrou PS (1983) Ergebnisse der Chemotherapie inoperabler nicht-kleinzelliger Bronchialkarzinome mit VP16-213 (Etoposid) und Cis-Platin. Onkologie 6:306–311.

    Article  PubMed  CAS  Google Scholar 

  46. Legha SS, Muggia FM (1979) Adjuvant chemotherapy in lung cancer; an appraisal of past studies. In: Muggia FM, Rozencweig M (eds) Lung cancer, progress in therapeutic research. Raven, New York, pp 405–410.

    Google Scholar 

  47. Livingston RB, Mooere TN, Heilbrunn L, Botomley R, Lehane D, Rivkin SE, Thigpen T (1978) Small cell carcinoma of the lung. Combined chemotherapy and radiation. A South West Group Study. Ann Intern Med 88:194.

    PubMed  CAS  Google Scholar 

  48. Longeval E, Klastersky J (1982) Combination chemotherapy with cisplatin and etoposide in bronchogenic squamous cell carcinoma and adenocarcinoma. Cancer 50:2751–2756.

    Article  PubMed  CAS  Google Scholar 

  49. Lowenbraun S, Bartolucci A, Smalley RV, Lynn M, Krauss St, Durant JR, and The Southeastern Cancer Study Group (1979) The superiority of combination chemotherapy over single agent chemotherapy in small cell lung carcinoma. Cancer 44:406–413.

    Article  PubMed  CAS  Google Scholar 

  50. Lung Cancer Study Group (1988) The benefit of adjuvant treatment for resection of locally of advanced non-small cell lung cancer. J Clin Oncol 6:9–17.

    Google Scholar 

  51. Martini N, Wittes R, Hilaris BS (1975) Oat-cell carcinoma of the lung. Clin Bull 5:144–148.

    PubMed  CAS  Google Scholar 

  52. Mehta C, Vogel SE (1982) Cyclic non-cross resistent combination chemotherapy (CT) for small cell lung cancer (SCLC) in remission (R) — 50% prolongation of remission duration without prolongation of survival and with enhanced toxicity. Proc Soc Clin Oncol 1:152 (abstract).

    Google Scholar 

  53. Merkle NM, Mikisch GH, Kaysr K, Drings P, Vogt-Moykopf I (1986) Surgical resection and adjuvant chemotherapy for small cell carcinoma. Thorac Cardiovasc Surg 34:39–42.

    Article  PubMed  CAS  Google Scholar 

  54. Mountain CF (1978) Clinical biology of small cell carcinoma: relationship to surgical therapy. Semin Oncol 3:272–279.

    Google Scholar 

  55. 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 10:137–145.

    PubMed  CAS  Google Scholar 

  56. Mulshine JL, Glatstein E, Ruckdeschel JC (1986) Treatment of non-small cell lung cancer. J Clin Oncol 4:1794-1715-1815.

    Google Scholar 

  57. Niederle N, Schütte J (1985) Chemothera-peutic results in small cell lung cancer. Recent Results Cancer Res 97:127–145.

    Article  PubMed  CAS  Google Scholar 

  58. Niederle N, Silcher RB, Bierbaum W, Mouratidou D, Seeber S, Schmidt CG (1980) Erste Ergebnisse mit dem ACO II-Protokoll beim inoperablen nicht kleinzelligen Bronchialkarzinom. Verh Dtsch Ges Inn Med 86:464–467.

    Google Scholar 

  59. Osterlind K (1989) Alternating or sequential chemotherapy in small cell lung cancer? Lung Cancer 5:173–177.

    Article  Google Scholar 

  60. Osterlind KS, Sörensen S, Hansen HH, et al. (1983) Continous versus alternating combination chemotherapy for advanced small cell carcinoma of the lung. Cancer Res 43:6085–6089.

    PubMed  CAS  Google Scholar 

  61. Payne DG, Arriagada R, Dombernowsky P, et al. (1989) The role of thoracic therapy in small cell carcinoma of the lung: a consensus report. Lung Cancer 5:135–138.

    Article  Google Scholar 

  62. Perloff M, Killenn JV, Wittes RE (1986) Small cell bronchogenic carcinoma. Curr Probi Cancer 10:171–214.

    Google Scholar 

  63. Postmus PE, Berendsen HH, Zandwijk N van, Splinter TAW, Burghouts ThM, Bakker W, and The EORTC Lung Cancer Cooperative Group (1987) Retreatment with the induction regimen in small cell lung cancer relapsing after an initial response to short term chemotherapy. Eur J Cancer Clin Oncol 23:1409–1411.

    Article  PubMed  CAS  Google Scholar 

  64. Rapp E, Pater JL, Willan A, et al. (1988) Chemotherapy can prolong survival in patients with advanced non-smallcell lung cancer — report of a Canadian multicenter randomized trial. J Clin Oncol 6:633–641.

    PubMed  CAS  Google Scholar 

  65. Salazar OM, Creech RH (1980) The state of the art „towards defining the role of radiation therapy in management of small cell bronchogenic carcinoma“. Int J Radiat Oncol Biol Phys 6:1103–1117.

    Article  PubMed  CAS  Google Scholar 

  66. Sculier JP, Klastersky J (1984) Progress in chemotherapy of non-small cell lung cancer. Eur J Cancer Clin Oncol 20:1329–1333.

    Article  PubMed  CAS  Google Scholar 

  67. Seifter EJ, Ihde DC (1988) Therapy of small cell lung cancer: a perspective on two decades of clinical research. Semin Oncol 15:279–299.

    Google Scholar 

  68. Shepherd FA, Evans WK, Feld R, Young V, Patterson GA, Ginsburg J, Johansen E (1988) Adjuvant chemotherapy following surgical resection for small cell carcinoma of the lung. J Clin Oncol 6:832–838.

    PubMed  CAS  Google Scholar 

  69. Sierocki JS, Hilaris BS, Hopfan S, et al. (1980) Small cell carcinoma of the lung. Experience with a six drug regimen. Cancer 45:417–422.

    Article  PubMed  CAS  Google Scholar 

  70. Sikic BJ, Daniels JR, Chak L, Alexander M, Köhler M, Carter SK (1981) POCC versus POCC/VAM therapy for small cell anaplastic (oat cell) lung cancer. In: Prestayko AW, et al. (eds) Nitrosoureas: current status and new development. Academic Press, New York, pp 221–231.

    Google Scholar 

  71. Smith IE, Evans BD, Harland SJ, Robinson BA (1985) High-dose cyclophosphamide with autologous bone marrow rescue after conventional chemotherapy in the treatment of small cell lung carcinoma. Cancer Chemother Pharmacol 14:120–124.

    Article  PubMed  CAS  Google Scholar 

  72. Souhami R (1985) Chemotherapy in non-small cell bronchial carcinoma. Thorax 40:641–645.

    Article  PubMed  CAS  Google Scholar 

  73. Plinter TAW (1989) Chemotherapy of small cell lung cancer: duration of treatment. Lung Cancer 5:186–195.

    Article  Google Scholar 

  74. Stahel RA, Ginsberg R, Havemann K, et al. (1989) Staging and prognostic factors in small cell lung cancer: a consensus report. Lung Cancer 5:119–126.

    Article  Google Scholar 

  75. Thatcher N, James RD, Steward WP, Barber PV, Feinmann D, Lawson BAM, Carroll KB (1985) Three months treatment with cyclophosphamide, VP-16-213, followed by methotrexate and thoracic radiotherapy for small cell lung cancer. Cancer 56:1332–1336.

    Article  PubMed  CAS  Google Scholar 

  76. Wolf M, Havemann K, Holle R, et al. (1987) Cisplatin/etoposide versus ifosfamide/etoposide combination chemotherapy in small-cell lung cancer: a multicenter German randomized trial. J Clin Oncol 5:1880–1889.

    PubMed  CAS  Google Scholar 

  77. Woods RL, Levi JA (1984) Chemotherapy for small cell lung cancer. A randomized study of maintenance therapy with cyclophosphamide, adriamycin, and vincristin after remission induction with cisplatinum, VP-16-213 and radiotherapy. Proc Am Soc Clin Oncol 3:214.

    Google Scholar 

  78. Zelen M (1973) Keynote address on biostatistic and data retrieval. Cancer Chemother Pep 34(2): 31–42.

    Google Scholar 

  79. Zinnreich ES, Baker RR, Ettinger DS, Order SE (1986) New frontiers in the treatment of lung cancer. CRC Crit Rev Oncol Hematol 3:279–308.

    Article  Google Scholar 

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  1. Abteilung Innere Medizin — Onkologie, Thoraxklinik der LVA Baden, Heidelberg-Rohrbach, Deutschland

    P. Drings

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Drings, P. (1990). Aktuelle medikamentöse Therapie des Bronchialkarzinoms. In: Verhandlungen der Deutschen Gesellschaft für Innere Medizin. Verhandlungen der Deutschen Gesellschaft für Innere Medizin, vol 96. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84317-4_39

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