{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T08:32:39Z","timestamp":1740126759842,"version":"3.37.3"},"reference-count":7,"publisher":"Georg Thieme Verlag KG","issue":"07","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>\n          Fragestellung Das Lungenkarzinom wird immer h\u00e4ufiger bei \u00e4lteren Patienten diagnostiziert. Gerade in dieser Altersgruppe fehlen jedoch kontrollierte Daten zur Indikationsstellung und Durchf\u00fchrbarkeit multimodaler Therapien. Daher vergleicht die vorliegende Studie \u00fcber und unter 70-j\u00e4hrige Patienten mit operiertem NSCLC-Stadium II bis IV (oligo) hinsichtlich Indikationsstellung, Therapieadh\u00e4renz und \u00dcberleben.<\/jats:p><jats:p>\n          Patienten und Methoden Eingeschlossen wurden 316 Patienten, 115 davon 70 Jahre oder \u00e4lter, mit NSCLC im Stadium II, III und oligometastatischem Stadium IV, die zwischen 2008 und 2018 in der Thoraxchirurgie am Universit\u00e4tsklinikum Gie\u00dfen in kurativer Absicht operiert wurden. Prim\u00e4re Endpunkte waren Indikationsstellung und Therapieadh\u00e4renz. Sekund\u00e4re Endpunkte waren therapieassoziierte Morbidit\u00e4t und Langzeit\u00fcberleben.<\/jats:p><jats:p>\n          Ergebnisse \u00c4ltere Menschen erhielten signifikant weniger Empfehlungen zur adjuvanten Therapie, sowohl Chemotherapie (OR=0,509) als auch Radiochemotherapie (OR=0,455). Im Vergleich zu den j\u00fcngeren Patienten beendeten weniger \u00e4ltere Patienten die Behandlung vollst\u00e4ndig (OR=0,423) und begannen seltener mit der Therapie (OR=4,49). Trotz einer \u00fcber die Jahre angestiegenen Zahl indizierter adjuvanter Therapien im Gesamtkollektiv blieb die Zahl therapierter \u00e4lterer Patienten gleich. Das 5-Jahres-\u00dcberleben \u00e4lterer Patienten war nach adjuvanter Behandlung besser (Stadium II, 51,9 vs. 31,8%; Stadium III, 29,0 vs. 25,8%).<\/jats:p><jats:p>\n          Schlussfolgerung Die stadiengerechte adjuvante Therapie des Lungenkarzinoms ist auch bei \u00fcber 70-j\u00e4hrigen Patienten grunds\u00e4tzlich sinnvoll und durchf\u00fchrbar. Sie wird bei \u00e4lteren Patienten seltener indiziert und durchgef\u00fchrt. \u00dcber die Jahre betrachtet blieb die Zahl therapierter \u00e4lterer Patienten trotz Indikationsausweitung unver\u00e4ndert. Da postoperativer Verlauf, Komorbidit\u00e4t, Gebrechlichkeit und Toxizit\u00e4t eine gro\u00dfe Rolle spielen, sollte statt des Alters die individuelle Einsch\u00e4tzung jedes Einzelfalls in einer interdisziplin\u00e4ren onkologischen Konferenz als Grundlage f\u00fcr Therapieentscheidungen dienen. Vielversprechend erscheinen neuere, potenziell besser vertr\u00e4gliche Medikamente wie bspw. Immuncheckpoint-Inhibitoren, die derzeit im Rahmen von Studien neoadjuvant in prim\u00e4r resektablen nodal-positiven Tumorstadien eingesetzt werden.<\/jats:p>","DOI":"10.1055\/a-1818-6773","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T23:01:01Z","timestamp":1655766061000},"page":"488-493","source":"Crossref","is-referenced-by-count":2,"title":["Adjuvante Therapie betagter Lungenkrebspatienten: Komparative Analyse von Indikationsstellung, Therapieadh\u00e4renz und Langzeit\u00fcberleben"],"prefix":"10.1055","volume":"76","author":[{"given":"Ansgar","family":"Scheffold","sequence":"additional","affiliation":[{"name":"Thoracic Surgery, Universitatsklinikum Giessen und Marburg GmbH Standort Giessen, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bastian","family":"Eul","sequence":"additional","affiliation":[{"name":"Medizinische KLinik II, Schwerpunkt Internistische Onkologie, Universitatsklinikum Giessen und Marburg GmbH Standort Giessen, Giessen, Germany"},{"name":"Thorakale Onkologie, Lungenkrebszentrum Mittelhessen, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Degen","sequence":"additional","affiliation":[{"name":"Pneumologie, Schwerpunkt Thorakale Onkologie, Evangelisches Krankenhaus Giessen, Giessen, Germany"},{"name":"Thorakale Onkologie, Lungenkrebszentrum Mittelhessen, Giessen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4214-4948","authenticated-orcid":false,"given":"Biruta","family":"Witte","sequence":"additional","affiliation":[{"name":"Thoracic Surgery, Universitatsklinikum Giessen und Marburg GmbH Standort Giessen, Giessen, Germany"},{"name":"Thoraxchirurgie, Lungenkrebszentrum Mittelhessen, Giessen, 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