{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T05:29:42Z","timestamp":1730870982386,"version":"3.28.0"},"reference-count":125,"publisher":"Georg Thieme Verlag KG","issue":"08","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Zerebrale Metastasen bei Patienten mit Lungenkarzinom im Stadium der Metastasierung finden sich bereits bei mehr als 30% Patienten zum Zeitpunkt der Erstdiagnose und manifestieren sich im Verlauf der Erkrankung bei 2 von 3 Patienten. Die zerebrale Krankheitsmanifestation wurde lange Zeit als prognostisch ung\u00fcnstig eingestuft. Betroffene Patienten wurden regelhaft von Therapiestudien unter Ber\u00fccksichtigung der ung\u00fcnstigen Prognose ausgeschlossen. Im Kontext zielgerichteter molekularer Therapiestrategien und etablierter immunonkologischer Systemtherapien stellt die Blut-Hirn-Schranke mittlerweile keine un\u00fcberwindbare Barriere mehr dar. Die Therapie von Hirnmetastasen erfordert aber stets die Betreuung in einem interdisziplin\u00e4ren Team und muss als Zentrumsaufgabe angesehen werden. Unter Ber\u00fccksichtigung von Anzahl, Gr\u00f6\u00dfe und Lokalisation der Hirnmetastasen, Neurologie und Allgemeinzustand, Komorbidit\u00e4ten, potenzieller Lebenserwartung und Wunsch des Patienten, aber auch Tumorbiologie inklusive molekularer Ver\u00e4nderungen, extrakranieller Tumorlast und Verf\u00fcgbarkeit einer ZNS-wirksamen Therapie erfolgt die differenzierte Therapieentscheidung. Hierbei werden mittlerweile h\u00e4ufig Systemtherapien sowie lokale neurochirurgische und strahlentherapeutische Therapiekonzepte kombiniert im Sinne optimierter und prognoseverbessernder Therapiestrategien.\n    <\/jats:p>","DOI":"10.1055\/a-2238-1840","type":"journal-article","created":{"date-parts":[[2024,1,25]],"date-time":"2024-01-25T00:10:26Z","timestamp":1706141426000},"page":"578-589","source":"Crossref","is-referenced-by-count":0,"title":["Hirnmetastasen"],"prefix":"10.1055","volume":"78","author":[{"given":"Christian","family":"Schulz","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Innere Medizin II, Universit\u00e4tsklinikum Regensburg, Regensburg, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Proescholdt","sequence":"additional","affiliation":[{"name":"Klinik und Poliklinik f\u00fcr Neurochirurgie, Universit\u00e4tsklinikum Regensburg, Regensburg, 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