PCI in resected small-cell lung cancer

Knisely, Jonathan; Sharma, Rajiv; Goenka, Anuj; Halthore, Aditya

doi:10.1016/s1470-2045(16)30453-3

Cited by 6 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…published a review recommending PCI therapy for p‐T1‐2N0M0 SCLC, yet the conclusion was debated by Knisely et al . among this subset of patients . On the basis of our earlier work, we observed a larger sample size of p‐T1‐2N0M0 SCLC patients to assess the benefit of PCI therapy.…”

Section: Introductionmentioning

confidence: 98%

Does surgically resected small‐cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation?

Lou

Zhong

et al. 2020

Thoracic Cancer

View full text Add to dashboard Cite

Background It has previously been demonstrated that surgically resected small‐cell lung cancer (SCLC) patients could benefit from prophylactic cranial irradiation (PCI). However, PCI in patients without lymph node involvement remains controversial. This study includes a larger sample size to evaluate the benefit of PCI therapy in this specific population. Methods The records of surgically resected SCLC patients without lymph node involvement (N0M0) in Shanghai Chest Hospital were retrospectively reviewed. Results Between January 2006 and May 2017, a total of 146 cases of surgically resected SCLC without lymph node involvement were included. A total of 46 patients received PCI therapy and 100 patients received no therapy. During the observation period, 12.0% (12/100) of the patients who did not receive PCI therapy developed brain metastases while 10.9% (5/46) of patients who received PCI therapy developed brain metastases. With regard to time to recurrence, no significant difference was observed among the groups (P = 0.798). Moreover, there was no significant difference in either the overall survival benefit (hazard ratio [HR] = 0.84, 95% confidence interval [CI]: 0.49–1.45, P = 0.532) or disease‐free survival rate (HR = 0.95, 95% CI: 0.52–1.75, P = 0.864). Conclusions The evidence obtained does not support PCI therapy in the management of surgically resected SCLC with no lymph node involvement. Key points Prophylactic cranial irradiation (PCI) remains controversial for resected small‐cell lung cancer (SCLC) without lymph node involvement. In this study, the results indicated that PCI does not reduce the risk of cerebral recurrence of resected p‐T1‐2N0M0 SCLC. This is the largest sample size study focused on PCI in resected p‐T1‐2N0M0 SCLC. Future revised versions of the guidelines should address this issue.

show abstract

Section: Introductionmentioning

confidence: 98%

Does surgically resected small‐cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation?

Lou

Zhong

et al. 2020

Thoracic Cancer

View full text Add to dashboard Cite

show abstract

“…Brain metastasis is associated with significant neurocognitive symptoms and poor survival and has been observed in more than 50% of patients with SCLC. 1 Although the use of prophylactic cranial irradiation (PCI) is debated in patients with very early stage SCLC, such as T1N0M0 disease, 2 PCI is currently considered a standard-of-care intervention in patients with LS-SCLC who achieve a complete or partial response to initial chemotherapy. 3 …”

Section: Introductionmentioning

confidence: 99%

Factors influencing the utilization of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer

Lok

Foster

et al. 2017

Advances in Radiation Oncology

View full text Add to dashboard Cite

PurposeBrain metastases are common in patients with limited-stage small cell lung cancer (LS-SCLC) due to the inability of most chemotherapeutics to penetrate the blood–brain barrier. Prophylactic cranial irradiation (PCI) is therefore recommended for use in patients with a good response to concurrent chemoradiotherapy. However, PCI is not always delivered; therefore, we investigated the reasons for PCI omission in patients who underwent therapy with curative intent.Methods and materialsWe retrospectively reviewed all patients with LS-SCLC who were treated with curative intent at our institution. Overall survival and cumulative incidence of brain metastasis were estimated by the Kaplan-Meier method. The Pearson χ2 test and Mann-Whitney U test were used to examine factors associated with PCI use, and prognostic factors were analyzed with Cox proportional hazards modeling.ResultsWe examined 208 patients who were treated for LS-SCLC at our institution. A total of 115 patients (55%) received PCI. The most common documented reason for PCI omission was patient refusal due to neurotoxicity concerns (38%). Physician assessment of being medically unfit (33%) and of advanced age (8%) were the second and third most common reasons, respectively. Karnofsky performance status and clinical American Joint Committee on Cancer stage but not PCI were significantly associated with overall survival. Only clinical stage remained an independent factor on multivariate analysis.ConclusionsApproximately half of patients with LS-SCLC ultimately receive PCI, generally for guideline-recommended reasons. The most common reason for PCI omission was patient concerns regarding neurotoxicity. Efforts to decrease PCI neurotoxicity, including hippocampal-sparing radiation and memantine use, may increase the use of this survival-improving intervention in eligible patients with LS-SCLC.

show abstract

“…Brain metastasis is associated with significant neurocognitive symptoms and poor survival and has been observed in more than 50% of patients with SCLC. 1 Although the use of prophylactic cranial irradiation (PCI) is debated in patients with very early stage SCLC, such as T1N0M0 disease, 2 PCI is currently considered a standardof-care intervention in patients with LS-SCLC who achieve a complete or partial response to initial chemotherapy. 3 PCI has been studied extensively in clinical trials and was shown to improve overall survival (OS) in patients with SCLC in 2 meta-analyses of phase 2 and 3 clinical trials.…”

Section: Introductionmentioning

confidence: 99%

The Factors Influencing the Utilization of Prophylactic Cranial Irradiation in Patients With Limited-Stage Small Cell Lung Cancer

Lok

Pietanza

Foster

et al. 2015

International Journal of Radiation Oncology*Biology*Physics

View full text Add to dashboard Cite

Purpose: Brain metastases are common in patients with limited-stage small cell lung cancer (LS-SCLC) due to the inability of most chemotherapeutics to penetrate the blood-brain barrier. Prophylactic cranial irradiation (PCI) is therefore recommended for use in patients with a good response to concurrent chemoradiotherapy. However, PCI is not always delivered; therefore, we investigated the reasons for PCI omission in patients who underwent therapy with curative intent. Methods and materials:We retrospectively reviewed all patients with LS-SCLC who were treated with curative intent at our institution. Overall survival and cumulative incidence of brain metastasis were estimated by the Kaplan-Meier method. The Pearson χ 2 test and Mann-Whitney U test were used to examine factors associated with PCI use, and prognostic factors were analyzed with Cox proportional hazards modeling. Results: We examined 208 patients who were treated for LS-SCLC at our institution. A total of 115 patients (55%) received PCI. The most common documented reason for PCI omission was patient refusal due to neurotoxicity concerns (38%). Physician assessment of being medically unfit (33%) and of advanced age (8%) were the second and third most common reasons, respectively. Karnofsky performance status and clinical American Joint Committee on Cancer stage but not PCI were significantly associated with overall survival. Only clinical stage remained an independent factor on multivariate analysis.

show abstract

PCI in resected small-cell lung cancer

Cited by 6 publications

References 5 publications

Does surgically resected small‐cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation?

Does surgically resected small‐cell lung cancer without lymph node involvement benefit from prophylactic cranial irradiation?

Factors influencing the utilization of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer

The Factors Influencing the Utilization of Prophylactic Cranial Irradiation in Patients With Limited-Stage Small Cell Lung Cancer

Contact Info

Product

Resources

About