Vol. 13. Núm. 67.
Páginas 3942-3952 (Noviembre 2022)

Actualizacion
Tumores neuroendocrinos pulmonares, cáncer de pulmón de células pequeñas y tumores metastásicos en el pulmón

Lung neuroendocrine tumors, small-cell lung cancer, and metastatic tumors in the lung

Á. Cantero-AcedoM. Castro-MartínezJ.I. de Granda-Orive
Doi : https://10.1016/j.med.2022.11.003
Opciones
Resumen

Las neoplasias neuroendocrinas pulmonares están constituidas por un extenso espectro de tumores pulmonares. Varían desde neoplasias con menor potencial metastásico a otras con un alto grado de malignidad que suponen aproximadamente un 19% de todos los tumores broncopulmonares primarios malignos, siendo el más frecuente el carcinoma pulmonar de células pequeñas (79%), seguido del carcinoma neuroendocrino de células grandes (16%), mientras que los carcinoides típicos y atípicos suponen aproximadamente el 5% restante. En el estadio limitado, el tratamiento de elección es una combinación de cisplatino y etopósido, junto con radioterapia de forma concurrente. En la enfermedad avanzada, el abordaje terapéutico es sistémico, basado principalmente en la quimioterapia (QT) pero, en la actualidad, la inmunoterapia tiene un papel importante en el tratamiento del carcinoma microcítico de pulmón, habiéndose incluido como terapia de primera línea junto con la QT. Los pulmones son el segundo lugar más frecuente de enfermedad metastásica, englobando todos los tipos histológicos (alcanzando casi el 30% de los casos) y son el único lugar de metástasis en el 20% de los casos.

Palabras clave
Carcinoma de células pequeñas de pulmón
Quimioterapia
Radioterapia
Tabaquismo
Abstract

Lung neuroendocrine tumors encompass an extensive spectrum of lung tumors. They range from neoplasms with lower metastatic potential to others with a high degree of malignancy that represent approximately 19% of all primary malignant bronchopulmonary tumors. The most frequent is small-cell lung carcinoma (79%) followed by large cell neuroendocrine carcinoma (16%) while typical and atypical carcinoids represent the approximately 5% of remaining tumors. In limited stages, the treatment of choice is a combination of cisplatin and etoposide along with concurrent radiotherapy. In advanced disease, the treatment approach is systemic and based mainly on chemotherapy (CT). However, at present, immunotherapy plays an important role in the treatment of microcytic lung carcinoma and was included as first-line therapy together with CT. The lungs are the second most common location of metastatic disease, encompassing all histological types (almost 30% of cases) and are the only site of metastasis in 20% of cases.

Keywords
Small-cell lung carcinoma
Chemotherapy
Radiotherapy
Tobacco use

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