Prophylactic Cranial Irradiation in Small-Cell Lung Cancer

Yang, Gary; Matthews, Richard H.

doi:10.1634/theoncologist.5-4-293

Cited by 20 publications

(26 citation statements)

References 29 publications

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“…[33][34][35][36] PCI is part of the standard treatment protocol for SCLC patients. 17 However, over the past 25 years, the diagnostic tools used to stage and evaluate SCLC patients have evolved.…”

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confidence: 99%

Detection of brain metastases from small cell lung cancer

Seute

Leffers

Velde

et al. 2008

Cancer

162

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BACKGROUNDThe aims of this study were to show 1) the effect of changing from computed tomography (CT) to magnetic resonance imaging (MRI) on the prevalence of detected brain metastases (BM) in patients with newly diagnosed small cell lung cancer (SCLC); 2) the difference in survival between patients with single and multiple BM; and 3) the effect of the change in patient labeling on eligibility for prophylactic brain irradiation.METHODSFrom 1980 to 2004, 481 consecutive patients with SCLC were enrolled. Brain imaging was routinely performed after diagnosis of SCLC. At the start of 1991, MRI replaced CT in almost all patients. All patients were regularly examined by a neurologist.RESULTSThe prevalence of detected BM was 10% in the CT era and 24% in the MRI era. In the CT era, all detected BM were symptomatic, whereas in the MRI era, 11% were asymptomatic. In both periods, patients labeled as single BM survived longer than those labeled as multiple BM. For patients labeled as single BM or multiple BM, survival was longer in the MRI era than in the CT era. The proportion of patients who were eligible for prophylactic cranial irradiation was lower in the MRI era.CONCLUSIONSThe estimated prevalence of BM increases when MRI is used instead of CT. Patients with a detected single BM survive longer than patients with multiple BM. The apparently increased survival in the MRI era can be attributed to the “Will Rogers phenomenon”. The use of MRI makes fewer patients eligible for prophylactic cranial irradiation. Cancer 2008. ©2008 American Cancer Society.

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confidence: 99%

Detection of brain metastases from small cell lung cancer

Seute

Leffers

Velde

et al. 2008

Cancer

162

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Section: Introductionmentioning

confidence: 99%

“…The results of several randomized trials and meta-analyses have shown that PCI reduces the incidence of brain metastases in patients with LS SCLC [1,13,18,32,36]. Application of PCI lowers the frequency of brain metastases (from 54% without PCI to 30% with PCI) and increases the survival rate (by 5.4% for 3-year overall survival) [3,9,21].The investigations of improvement efficiency of PCI refer to the total dose of PCI and timing of PCI in relation to chemoradiotherapy [19,27,36].The aim of this study is to evaluate the effectiveness of PCI timing in patients with LS SCLC. …”

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confidence: 99%

Comparison of the Effectiveness of “Late” and “Early” Prophylactic Cranial Irradiation in Patients with Limited-Stage Small Cell Lung Cancer

2010

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“…The incidence of BM is directly proportional with the survival time, indicating a potential for further increase with implementation of more effective treatment protocols (Komaki, 1981;van Oosterhout, 1996). Compared to patients with LS-SCLC, the risk for BM occurrence is higher for patients with ES-SCLC reaching 69% at 2-years of diagnosis (van Oosterhout, 1996;Yang GY & Matthews, 2000). Impact of BM on socioeconomic issues and quality of life is significantly worse than the impact of failure at other metastatic sites.…”

Section: Prophylactic Cranial Irradiationmentioning

confidence: 99%