Low dose elective brain irradiation in small cell carcinoma of the lung

Beiler, David D.; Kane, Robert C.; Bernath, Albert M.; Cashdollar, Michael R.

doi:10.1016/0360-3016(79)90598-4

Cited by 84 publications

(9 citation statements)

References 6 publications

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“…A total of 16 RCTs, (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) published between 1977 and 2007, were considered eligible for inclusion in the present study. The principal characteristics of those RCTs are summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…In 2 studies, (6,8) PCI was given as consolidation therapy at the end of chemotherapy, before the response had been evaluated. A total of 10 studies (4)(5)(6)11,12,14,15) included patients regardless of their disease stage (limited or extensive). (6)(7)(8)(9)13) In contrast, 6 studies included only patients with limited disease, whereas 1 study included only those with extensive disease.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 7 studies (894 patients) (4,5,7,11,15) evaluated the role of PCI in patients who had a complete response after induction chemotherapy. A total of 5 studies (6,9,(12)(13)(14) evaluated the role of PCI administered at the start of induction chemotherapy in patients considered free of brain metastases. A total of 7 studies (894 patients) (4,5,7,11,15) evaluated the role of PCI in patients who received it during induction chemotherapy.…”

Section: Resultsmentioning

confidence: 99%

“…These findings are similar to those of the meta-analysis published in 1999, showed a significant reduction in the incidence of brain metastases and no increase in evident neurological complications in the patients treated with PCI. (6,(8)(9)(10)12) However, the beneficial effects of PCI on overall survival remained unclear until 1999, when one group of authors performed a meta-analysis of 7 RCTs involving 987 patients in order to guide clinical practice recommendations. (20) The clinical trials included in that metaanalysis met strict inclusion criteria, i.e., trials involving patients who were treated with systemic chemotherapy (with or without thoracic radiation therapy), who had a complete clinical response, and who were subsequently randomized to receive or not to receive PCI.…”

Section: Discussionmentioning

confidence: 99%

“…On the basis of the abovementioned data, several randomized clinical trials (RCTs) have investigated the role of prophylactic cranial irradiation (PCI) in patients with extensive or limited SCLC. (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) A meta-analysis published in 1999 and including 7 RCTs involving 987 patients with SCLC and complete response to chemotherapy showed a 5.4% increase in the three-year survival of those undergoing PCI. (20) However, ever since that meta-analysis was published, several RCTs have been published, and uncertainties still remain regarding the indications for PCI use in patients with extensive disease and in those with limited disease and an incomplete response to chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

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Trinta anos de irradiação craniana profilática em pacientes com câncer de pulmão de pequenas células: uma meta-análise de ensaios clínicos randomizados

et al. 2012

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Objective: To determine the role of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC). Methods: We searched various databases, selecting randomized clinical trials published in journals or conference proceedings within the last 30 years and investigating the role of PCI in the mortality of patients with SCLC, submitted to PCI or not. Results: Sixteen randomized clinical trials, collectively involving 1,983 patients, were considered eligible for inclusion. Of those 1,983 patients, 1,021 were submitted to PCI and 962 were not. Overall mortality was 4.4% lower in the patients submitted to PCI than in those who were not Descritores: Carcinoma de pequenas células do pulmão; Radioterapia; Análise de sobrevida.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Trinta anos de irradiação craniana profilática em pacientes com câncer de pulmão de pequenas células: uma meta-análise de ensaios clínicos randomizados

et al. 2012

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Neurologic disorders in patients with small cell lung cancer

Sculier

Feld

Evans

et al. 1987

Cancer

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In a series of 641 patients with small cell lung cancer, 189 (29.5%) had at least one neurologic disorder either at the time of presentation or during the subsequent clinical course of the cancer. The total number of neurologic disorders was 210, which included brain metastases (75.7%), meningeal carcinomatosis (6.7%), intramedullary metastases (2.4%), epidural metastases (11.0%), hyponatremia producing CNS symptoms (3.3%), and Eaton-Lambert syndrome (1.0%). The most common signs and symptoms were motor dysfunction and confusion. The overall survival of patients with any neurologic disorder was compared to that of patients without neurologic problems. There was no difference between the survival curves for the first year and a half, but patients without neurologic complications had a greater probability of long-term survival (log-rank P = 0.03). There were no statistically significant differences when this comparison was made according to stage of disease. When a neurologic disorder related to cancer occurred, the survival time from the date of that diagnosis was usually short. The neurologic disorder was the immediate cause of death in the majority of cases. In patients who achieved a complete remission, the administration of prophylactic cranial irradiation (PCI) significantly reduced the risk of developing brain metastases as the initial site of the relapse (log-rank P = 0.0034). After adjustment for performance status and extent of disease, the survival of complete responders treated with and without PCI was not significantly different. We conclude that neurologic complications are a frequent and serious problem in patients with SCLC.

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Prophylactic cranial irradiation in limited-stage small cell lung cancer

Liengswangwong

Bonner

Shaw

et al. 1995

Cancer

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Background. The role of prophylactic cranial irradiation (PCI) for patients with limited‐stage small cell lung cancer (LSSCLC) remains a controversial issue. This study evaluated PCI in patients with LSSCLC who achieved a complete response to initial chemotherapy. Methods. A retrospective case study of all nonprotocol patients with LSSCLC examined at our institution from 1982 to 1990 was performed. Of the 67 nonprotocol patients who were treated with combination chemotherapy (cyclophosphamide‐based) and thoracic radiotherapy during those years, 43 achieved a complete response. Twenty‐four patients prophylactic cranial irradiation (PCI+) (25‐36 Gy in 10‐16 fractions), and 19 did not (PCI‐) at the physician's or patient's discretion. Results. The distribution of prognostic factors between the PCI+ and PCI‐ groups was well balanced. Of the PCI+ patients, the 2‐year actuarial freedom from relapse in the central nervous system was 93% versus 47% for the PCI‐ patients (log rank analysis, P = 0.001). An initial central nervous system relapse developed in 2 of the 24 PCI+ patients as the only site of failure versus 7 of 19 PCI‐ patients (P = 0.003). The 2‐year actuarial overall survival was 50% for the PCI+ patients versus 21% for the PCI‐ patients [P = 0.01). The addition of prophylactic cranial irradiation was the only significant factor contributing to an improvement in time to central nervous system relapse and survival for the PCI+ patients. There were five patients alive at the time of this report, and all prophylactic cranial irradiation. None had cognitive or neurologic impairment. Conclusions. Prophylactic cranial irradiation may contribute to improved survival in patients with LSSCLC who achieve a complete response after chemotherapy and thoracic radiation therapy. Cancer 1995;75:1302‐9.

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Low dose elective brain irradiation in small cell carcinoma of the lung

Cited by 84 publications

References 6 publications

Trinta anos de irradiação craniana profilática em pacientes com câncer de pulmão de pequenas células: uma meta-análise de ensaios clínicos randomizados

Trinta anos de irradiação craniana profilática em pacientes com câncer de pulmão de pequenas células: uma meta-análise de ensaios clínicos randomizados

Neurologic disorders in patients with small cell lung cancer

Prophylactic cranial irradiation in limited-stage small cell lung cancer

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