Skip to main content
Top

2021 | OriginalPaper | Hoofdstuk

6. Longtumoren

Auteur : J. J. C. Verhoeff, MD PhD

Gepubliceerd in: Radiotherapie bij de oncologische patiënt

Uitgeverij: Bohn Stafleu van Loghum

share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Samenvatting

Inhoud – 1 Inleiding – 2 Diagnostiek – 3 Behandeling – 4 Follow-up: toxiciteit en bijwerkingen. Longtumoren vormen in aantal de grootste groep van alle kankersoorten, omdat ze sekseaspecifiek voorkomen. Ongeveer de helft van de longtumoren wordt pas ontdekt in stadium IV, waarbij enkel palliatieve behandeling mogelijk is. Niet-kleincellige longtumoren vormen de grootste subgroep, met chemotherapie, bestraling en immuuntherapie als belangrijkste behandelingen. De PET-CT is belangrijk bij de diagnostiek en bij de planning van radiotherapie. Radiotherapie wordt (stereotactisch) curatief gegeven in plaats van chirurgie in stadium I en II, standaard gefractioneerd gecombineerd met chemotherapie in stadium III en in een kort schema palliatief in stadium IV. Beweging door ademhaling wordt meegenomen in de planning via het ITV-concept of met complexe technieken als gating en breathhold. Acute bijwerkingen van radiotherapie zijn met name vermoeidheid, oesofagitis en hoestklachten. Op lange termijn kan een stralingsfibrose ontstaan, kan de longfunctie beperkter raken en kunnen hart- en vaatziekten optreden. Daarom is protonenbehandeling in goed geselecteerde patiënten waarschijnlijk gerechtvaardigd.
Literatuur
3.
go back to reference Naruke T. The spread of lung cancer and its relevance to surgery. Nippon Kyobu Geka Gakkai Zasshi. 1967;68:1607–21. Naruke T. The spread of lung cancer and its relevance to surgery. Nippon Kyobu Geka Gakkai Zasshi. 1967;68:1607–21.
6.
go back to reference Tekatli H, Duijm M, Oomen-de Hoop E, Verbakel W, Schillemans W, Slotman BJ, Nuyttens JJ, Senan S. Normal Tissue Complication Probability Modeling of Pulmonary Toxicity After Stereotactic and Hypofractionated Radiation Therapy for Central Lung Tumors. Int J Radiat Oncol. 2018;100(3):738–47. https://www.ncbi.nlm.nih.gov/pubmed/29413285.CrossRef Tekatli H, Duijm M, Oomen-de Hoop E, Verbakel W, Schillemans W, Slotman BJ, Nuyttens JJ, Senan S. Normal Tissue Complication Probability Modeling of Pulmonary Toxicity After Stereotactic and Hypofractionated Radiation Therapy for Central Lung Tumors. Int J Radiat Oncol. 2018;100(3):738–47. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​29413285.CrossRef
7.
go back to reference Videtic GM, Paulus R, Singh AK, Chang JY, Parker W, Olivier KR, Timmerman RD, Komaki RR, Urbanic JJ, Stephans KL, Yom SS, Bradley JD. Long-term follow-up on NRG oncology RTOG 0915 (NCCTG N0927): a randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer. Int J Radiat Oncol. 2019;103(5):1077–84. https://www.ncbi.nlm.nih.gov/pubmed/30513377.CrossRef Videtic GM, Paulus R, Singh AK, Chang JY, Parker W, Olivier KR, Timmerman RD, Komaki RR, Urbanic JJ, Stephans KL, Yom SS, Bradley JD. Long-term follow-up on NRG oncology RTOG 0915 (NCCTG N0927): a randomized phase 2 study comparing 2 stereotactic body radiation therapy schedules for medically inoperable patients with stage I peripheral non-small cell lung cancer. Int J Radiat Oncol. 2019;103(5):1077–84. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​30513377.CrossRef
10.
go back to reference Wang EH, Corso CD, Rutter CE, Park HS, Chen AB, Kim AW, Wilson LD, Decker RH, Yu JB. Postoperative radiation therapy is associated with improved overall survival in incompletely resected stage II and III non-small-cell lung cancer. J Thorac Oncol. 2015;33(25):2727–34. https://www.ncbi.nlm.nih.gov/pubmed/26101240. Wang EH, Corso CD, Rutter CE, Park HS, Chen AB, Kim AW, Wilson LD, Decker RH, Yu JB. Postoperative radiation therapy is associated with improved overall survival in incompletely resected stage II and III non-small-cell lung cancer. J Thorac Oncol. 2015;33(25):2727–34. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​26101240.
16.
go back to reference Slotman BJ, Faivre-Finn C, Van Tinteren H, Keijser A, Praag J, Knegjens J, Hatton M, Van Dam I, Van der Leest A, Reymen B, Stigt J, Senan S. Which patients with ES-SCLC are most likely to benefit from more aggressive radiotherapy: a secondary analysis of the Phase III CREST trial. Lung Cancer. 2017;108:150–3. https://www.ncbi.nlm.nih.gov/pubmed/28625628.CrossRef Slotman BJ, Faivre-Finn C, Van Tinteren H, Keijser A, Praag J, Knegjens J, Hatton M, Van Dam I, Van der Leest A, Reymen B, Stigt J, Senan S. Which patients with ES-SCLC are most likely to benefit from more aggressive radiotherapy: a secondary analysis of the Phase III CREST trial. Lung Cancer. 2017;108:150–3. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​28625628.CrossRef
18.
go back to reference Le Péchoux C, Dunant A, Senan S, Wolfson A, Quoix E, Faivre-Finn C, Ciuleanu T, Arriagada R, Jones R, Wanders R, Lerouge D, Laplanche A. Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99-01, EORTC 22003-08004, RTOG 0212, and IFCT 99-01): a randomised clinical trial. Lancet Oncol. 2009;10(5):467–74. https://www.ncbi.nlm.nih.gov/pubmed/19386548.CrossRef Le Péchoux C, Dunant A, Senan S, Wolfson A, Quoix E, Faivre-Finn C, Ciuleanu T, Arriagada R, Jones R, Wanders R, Lerouge D, Laplanche A. Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99-01, EORTC 22003-08004, RTOG 0212, and IFCT 99-01): a randomised clinical trial. Lancet Oncol. 2009;10(5):467–74. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​19386548.CrossRef
19.
go back to reference Takahashi T, Yamanaka T, Seto T, Harada H, Nokihara H, Saka H, Nishio M, Kaneda H, Takayama K, Ishimoto O, Takeda K, Yamamoto N. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18(5):663–71. https://www.ncbi.nlm.nih.gov/pubmed/28343976.CrossRef Takahashi T, Yamanaka T, Seto T, Harada H, Nokihara H, Saka H, Nishio M, Kaneda H, Takayama K, Ishimoto O, Takeda K, Yamamoto N. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2017;18(5):663–71. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​28343976.CrossRef
20.
21.
go back to reference Higgins KA, O’Connell K, Liu Y, Gillespie TW, McDonald MW, Pillai RN, Patel KR, Patel PR, Robinson CG, Simone CB II, Owonikoko TK, Behera M. National Cancer Database Analysis of Proton Versus Photon Radiation Therapy in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2016;97(1):128–37. https://www.ncbi.nlm.nih.gov/pubmed/27979443.CrossRef Higgins KA, O’Connell K, Liu Y, Gillespie TW, McDonald MW, Pillai RN, Patel KR, Patel PR, Robinson CG, Simone CB II, Owonikoko TK, Behera M. National Cancer Database Analysis of Proton Versus Photon Radiation Therapy in Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys. 2016;97(1):128–37. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​27979443.CrossRef
23.
go back to reference Bradley JD, Hu C, Komaki RR, Masters GA, Blumenschein GR, Schild SE, Bogart JA, Forster KM, Magliocco AM, Kavadi VS, Narayan S, Choy H. Long-term results of NRG oncology RTOG 0617: standard- versus high-dose chemoradiotherapy with or without cetuximab for unresectable stage III non-small-cell lung cancer. J Clin Oncol. 2020;38(7):706–14. https://www.ncbi.nlm.nih.gov/pubmed/31841363.CrossRef Bradley JD, Hu C, Komaki RR, Masters GA, Blumenschein GR, Schild SE, Bogart JA, Forster KM, Magliocco AM, Kavadi VS, Narayan S, Choy H. Long-term results of NRG oncology RTOG 0617: standard- versus high-dose chemoradiotherapy with or without cetuximab for unresectable stage III non-small-cell lung cancer. J Clin Oncol. 2020;38(7):706–14. https://​www.​ncbi.​nlm.​nih.​gov/​pubmed/​31841363.CrossRef
Metagegevens
Titel
Longtumoren
Auteur
J. J. C. Verhoeff, MD PhD
Copyright
2021
Uitgeverij
Bohn Stafleu van Loghum
DOI
https://doi.org/10.1007/16013_2020_17