[Increased incidence of bronchial carcinomas. What is new in therapy and diagnosis?]

The increasing incidence and continuing poor prognosis of lung cancer make new therapeutic concepts necessary. For stage I and stage II disease, surgery remains the treatment of choice. In the case of inoperable patients, radiotherapy, used alone, may be a curative alternative. To improve the prognosis of stages II and III of non-small-cell lung cancer, multi-modal treatments such as neoadjuvant chemotherapy, combined chemo-/radiotherapy and post-operative irradiation are still being researched. Although present results indicate higher survival rates, these approaches have not yet become standard. The palliative options for stages III and IV have also clearly been expanded in recent years, so that late-stage lung cancer may yet respond to treatment. Such options are, in particular, invasive bronchoscopic procedures, such as treatment with the Nd-YAG laser, cryotherapy, dilatation and the implantation of stents, or intraluminal irradiation. The major and decisive measure, however, is still prevention which, for 85% of all lung cancer consists in the rejection of nicotine abuse. In the meantime, sensitive methods of early diagnosis have also become available. However, they are invasive and thus not suitable for large-scale screening, but are reserved for high-risk patients. Non-invasive methods are currently under development.