[Implementation of the German guideline for the prevention, diagnosis, treatment and follow-up of non-small cell lung cancer at the Diakoniekrankenhaus Halle/Saale]. / Umsetzung der aktuellen S3-Leitlinie zur Prävention, Diagnostik, Therapie und Nachsorge des nicht-kleinzelligen Lungenkarzinoms am Diakoniekrankenhaus Halle/Saale.

BACKGROUND: More than three years since the release of the german guideline for the prevention, diagnosis, treatment and follow-up of lung cancer the database in terms of the implementation of guideline recommendations is deficient. The aim of this article is to analyze the implementation of the recommended algorithms for first-line therapy of non-small cell lung cancer. PATIENTS AND METHODS: On the basis of the patients records we determined all cases of newly diagnosed non-small cell lung cancer which received a first-line therapy at the Diakoniekrankenhaus Halle/Saale between January 2010 and December 2011. The demographic data, tumor stage, time of diagnosis and performed first-line therapy were documented. Each case was assigned to the groups "guideline-adherent treatment" or "deviation from guideline recommendation" in dependency of its tumor stage. For this assignment the corresponding algorithms from guideline chapter "Therapy of non-small lung cancer" were used. RESULTS: A total of 126 from 148 cases (85%) received guideline-adherent treatment. Deviation from guideline recommendation was found in 22 cases (15%). The categories "poor performance status", "technical factors", "patient decision" and "others" were determined as the main reasons for non guideline-adherent treatment. CONCLUSIONS: Based on the analyzed population this study determined a high grade of guideline adherence at the period of investigation. Otherwise it shows that guideline recommendations cannot include each individual factor of the complex lung cancer disease. It could be found a wide range of reasons for deviation from the guideline recommendations.

[Risk assessment of bronchial cancer surgery using quantitative lung perfusion scintigraphy]. / Risikoeinschätzung einer operativen Therapie des Bronchialkarzinoms mit Hilfe der quantitativen Lungenperfusionsszintigraphie.

28 patients with bronchogenic carcinoma were studied to predict lung function after thoracic resectional surgery, i.e. the functional operability, employing preoperative vital capacity (VC), forced expiratory volume (FEV1) and perfusion lung imaging. The perfusion scan was divided into 12 regions of interest which were semiquantitated to determine the relative distribution of perfusion as a fraction of the total perfusion. The planned reduction of lung parenchyma was expressed as percent of total perfusion, and the expected decrease in VC and FEV1, i.e. the predicted postoperative function of the lung, was calculated. The comparison of the predicted functional lung capacity with the re-estimated lung function (VC and FEF1) 6 months after surgery showed high correlation coefficients for both VC and FEV1. Semiquantitative perfusion scintigraphy of the lung helps to determine the extent of surgery possible in the individual therapy of lung cancer and is especially important in patients with a high operative risk.