Strahlentherapeutische Optionen bei Hirnmetastasen des kleinzelligen Lungenkarzinoms

Context: Small cell lung cancer is one of the most common primary tumors in patients with brain metastases. These patients usually have a poor prognosis. Material and methods: Research of the literature and analysis of clinical trials. Results: Personalized treatment approaches are very important. Prognostic scores can help select the appropriate treatment. As the tumors are very sensitive to radiotherapy and chemotherapy and as multiple brain metastases are common, resection of metastases plays a minor role. Also the results after chemotherapy alone have not been convincing. Whole brain radiotherapy (WBRT) alone is considered the standard treatment despite unsatisfactory results. Small studies have combined WBRT and chemotherapy. Although the results have been encouraging, the combined approach has not been introduced as a new standard. After therapeutic and prophylactic WBRT, new or recurrent brain metastases can be controlled with radiosurgery. Conclusions: However, patient prognosis remains poor despite new treatment approaches. Randomized trials are urgently required.