Macha H N
Pneumologische Abteilung, Lungenklinik Hemer.
Internist (Berl). 2003 Jun;44 Suppl 1:S28-34. doi: 10.1007/s00108-003-0931-7.
Bronchial carcinoma still has a dark prognosis and therapeutic progress remains painfully slow: the 5-year survival rate raised in the last 20 years from 11 to 15%. There are no early symptoms by the tumor and detection by screening is not effective. Worldwide incidence is raising, the falling rates in men in the western world have been compensated by a steep increase in eastern Europe an Asia. Cigarette smoking is in 85% the main cause of this epidemic. Better understanding of genetic predisposition may identify patients at higher risk. Tumor in stage IA-IIB of non small cell carcinoma could gain by neoadjuvant chemotherapy, what is more probable for stage IIA and IIIB. Radiation therapy in combination with chemotherapy improves survival in inoperable stage IIIB. In stage IV disease palliative chemotherapy is superior to best supportive care.
支气管癌的预后仍然很差,治疗进展依然极其缓慢:在过去20年中,5年生存率仅从11%提高到了15%。肿瘤早期没有症状,筛查检测效果不佳。全球发病率正在上升,西方世界男性发病率的下降已被东欧和亚洲的急剧上升所抵消。85%的病例主要病因是吸烟。对遗传易感性的更好理解可能有助于识别高危患者。非小细胞癌IA-IIB期的肿瘤可通过新辅助化疗获益,IIA期和IIIB期更有可能。放疗联合化疗可提高IIIB期无法手术患者的生存率。在IV期疾病中,姑息化疗优于最佳支持治疗。