Diagnostik und Therapie des lokal fortgeschrittenen inoperablen NSCLC
摘要
Locally advanced inoperable NSCLC refers to tumor stages in which there are no distant metastases but where surgical treatment is no longer an option due to the local findings (e.g., tumor size, infiltration of neighboring structures or lymph node metastases). This usually affects tumor stages IIIB and IIIC, sometimes also stage IIIA. The treatment of choice in inoperable stage III is simultaneous definitive chemoradiotherapy. This is defined as the combined use of radiotherapy and cytostatically effective substances. In simultaneous chemoradiotherapy, chemotherapy is applied at the same time as irradiation. The treatment is carried out with a curative intention. If the tumor is positive for programmed cell death ligand 1 (PD-L1), i.e., has at least 1% PD-L1 expression, then consolidating immunotherapy with the checkpoint inhibitor durvalumab should be carried out over 1 year. This is valid for squamous cell carcinomas as well as for nonsquamous cell carcinomas.