Neue radioonkologische Therapiekonzepte beim nicht metastasierten Lungenkarzinom

Zusammenfassung

Die Strahlentherapie nimmt in der Behandlung des nicht metastasierten Lungenkarzinoms eine entscheidende Rolle ein, da sie sowohl einen kurativen Therapieansatz und zudem eine Verbesserung der krankheitsbedingten Symptome bietet. Als primäre Behandlungsmethode oder als (neo-)adjuvante Therapie nach einer Operation können die Kontroll- und Überlebensraten erhöht und damit die onkologischen Therapieergebnisse verbessert werden. Moderne Techniken wie die stereotaktische Strahlentherapie (SBRT) ermöglichen ein präzises Anvisieren des Tumors, wodurch die Strahlenbelastung des gesunden Gewebes minimiert und die Behandlungsdauer verkürzt werden. Die Synergie zwischen Strahlentherapie und systemischen Behandlungen, einschl. der Immuntherapie, führt zu einer weiteren Verbesserung der Behandlungsergebnisse. Die Immuntherapie verstärkt die körpereigene Immunreaktion gegen Tumorzellen und kann so die Wirksamkeit der Strahlentherapie erhöhen. Gleichermaßen werden die Mechanismen der Immuntherapie durch das Potenzial der Strahlentherapie, die Mikroumgebung des Tumors zu modulieren, verstärkt. Daher kann eine Kombination aus Strahlen- und Immuntherapie eine bessere Tumorkontrolle und damit Überlebensvorteile für den behandelten Patienten bieten. Zusätzlich maximiert eine multidisziplinäre Therapie aus Strahlentherapie, Chirurgie und Chemotherapie/Immuntherapie die Wirksamkeit der Behandlung und minimiert zeitgleich die Toxizität. In diesem Artikel geben wir einen Überblick über moderne Behandlungstechniken der Strahlentherapie und über mögliche Entwicklungen in naher Zukunft.

Abstract

Radiotherapy plays a critical role in the management of non-metastatic lung cancer, offering curative potential and symptom relief. It serves as a primary treatment modality or adjuvant therapy post-surgery, enhancing local control and survival rates. Modern techniques like Stereotactic Body Radiotherapy (SBRT) enable precise tumor targeting, minimizing damage to healthy tissue and reducing treatment duration. The synergy between radiotherapy and systemic treatments, including immunotherapy, holds promise in improving outcomes. Immunotherapy augments the immune response against cancer cells, potentially enhancing radiotherapy’s efficacy. Furthermore, radiotherapy’s ability to modulate the tumor microenvironment complements the immunotherapy’s mechanism of action. As a result, the combination of radiotherapy and immunotherapy may offer superior tumor control and survival benefits. Moreover, the integration of radiotherapy with surgery and chemotherapy in multidisciplinary approaches maximizes treatment efficacy while minimizing toxicity. Herein we present an overview on modern radiotherapy and potential developments in the close future.

Schlüsselwörter

stereotaktische Strahlentherapie - nicht kleinzelliger Lungenkarzinom - Immuntherapie - Multidisziplin

Keywords

stereotactic body radiation therapy - non-small cell lung cancer - immunotherapy - multidiscipline

Publication History

Received: 29 April 2024

Accepted after revision: 15 July 2024

Article published online:
13 August 2024

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