Hirnmetastasen beim Lungenkarzinom

Noch immer gilt die Prognose von Patienten mit Lungenkarzinom als infaust, sobald eine Hirnmetastasierung auftritt. Dennoch ist der ehemals vorherrschende therapeutische Nihilismus heute einem stratifizierten multimodalen Therapiekonzept gewichen. Bei der Mehrzahl der Patienten kann die neurologische Symptomatik und damit die Lebensqualität deutlich gebessert werden. Die Lebenserwartung hat sich gegenüber einer rein antiödematösen Therapie verdoppelt, für Subgruppen mit günstigem Prognoseprofil sogar vervielfacht.

Hirnmetastasen solider Tumoren werden in der wissenschaftlichen Literatur häufig als gemeinsame Entität behandelt. Dies führte jedoch dazu, dass Studienergebnisse oder stratifizierte Erfahrungsberichte für einzelne Tumorentitäten eher selten vorliegen. Gerade in der Abschätzung zwischen lokaler und systemischer Kontrolle offenbart jedoch die jeweilig zugrundeliegende Tumorentität ihre Bedeutung.

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