Intravaskuläre Therapieverfahren zu lokoregionalen Therapien von Lungentumoren

Zusammenfassung

Hintergrund Die Inzidenz von Lungenkarzinomen hat im letzten Jahrhundert stark zugenommen. Darüber hinaus ist die Lunge der häufigste Ort der Metastasierung. Trotz der verbesserten Diagnostik und Therapie von Lungenmalignomen ist die Prognose der Patienten noch immer unbefriedigend. Lokoregionäre chemotherapeutische Techniken zur Behandlung von Lungenmalignomen haben heutzutage die Aufmerksamkeit der Forschung auf sich gezogen. Ziel dieses Übersichtsartikels ist es, verschiedene lokoregionale intravaskuläre Techniken und deren Behandlungsprinzipien vorzustellen und die jeweiligen Vor- und Nachteile als palliative und neoadjuvante Behandlungsmethode bei der Behandlung von Lungenmalignomen zu evaluieren.

Methode Die verschiedenen Verfahren bei der Behandlung von Lungenmalignomen wie isolierte Lungenperfusion (ILP), selektive pulmonale Arterienperfusion (SPAP), transpulmonale Chemoembolisation (TPCE), Bronchialarterieninfusion (BAI), Bronchialarterienchemoembolisation (BACE) und intraarterielle Chemoperfusion (IACP) werden vergleichend bewertet.

Ergebnisse Lokoregionale intravaskuläre Chemotherapieverfahren erweisen sich als vielversprechende Behandlungsoptionen bei der Behandlung von malignen Lungentumoren. Um optimale Ergebnisse zu erreichen, sollte mittels lokoregionaler Technik eine möglichst hohe Aufnahme des Chemotherapeutikums in das Zielgewebe mit schneller systemischer Clearance erzielt werden.

Schlussfolgerung Unter den verschiedenen Behandlungsoptionen bei Lungenmalignomen ist die TPCE das am besten evaluierte Behandlungskonzept. Allerdings sind weitere Studien nötig, um das optimale Behandlungskonzept mit den besten klinischen Ergebnissen zu definieren.

Kernaussagen 

• Es existieren verschiedene Verfahren für die intravaskuläre Chemotherapie zur Behandlung von Lungenmalignomen.

• Die transpulmonale Chemoembolisation (TPCE) ist derzeit das am besten evaluierte Therapieverfahren bei Lungenmalignomen.

• Die Thermoablation nach neoadjuvanter Chemoperfusion stellt ein vielversprechendes Therapieverfahren bei Lungenmalignomen dar.

Zitierweise

• Vogl TJ, Mekkawy A, Thabet DB. Intravascular Treatment Techniques for Locoregional Therapies of Lung Tumors. Fortschr Röntgenstr 2023; 195: 579–585

Abstract

Background Lung cancer incidence has greatly increased over the past century. Moreover, the lung is the most common site of metastatic involvement. Despite improvements in the diagnosis and treatment of lung malignancies, patient prognosis is still unsatisfactory. Locoregional chemotherapeutic techniques for the treatment of lung malignancies are the current focus of research. The aim of this review article is to present different locoregional intravascular techniques and their treatment principles and to assess the pros and cons of each of them as a palliative and neoadjuvant treatment method in the treatment of lung malignancy.

Method The different methods for the treatment of malignant lung lesions such as isolated lung perfusion (ILP), selective pulmonary artery perfusion (SPAP), transpulmonary chemoembolization (TPCE), bronchial artery infusion (BAI), bronchioarterial chemoembolization (BACE), and intraarteriel chemoperfusion (IACP) are evaluated comparatively.

Results Locoregional intravascular chemotherapy procedures are proving to be promising treatment options in the management of malignant lung tumors. In order to achieve optimal results, the locoregional technique should be used to achieve the highest possible uptake of the chemotherapeutic agent into the target tissue with rapid systemic clearance.

Conclusion Among the various treatment options for lung malignancies, TPCE is the best evaluated treatment concept. However, further studies are necessary to define the optimal treatment concept with the best clinical outcomes.

Key words

chemoembolization - interventional procedures - pulmonary metastases - lung cancer - locoregional techniques

Publication History

Article published online:
29 August 2023

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