Prophylactic cranial irradiation in small cell lung cancer: a single institution experience

Naidoo, Jarushka; Kehoe, Molly; Sąsiadek, W.; Hacking, D.; Calvert, Paula

doi:10.1007/s11845-013-0977-z

Cited by 5 publications

(5 citation statements)

References 16 publications

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“…Analysis of 34 patient cases without cranial metastasis who received prophylactic cranial irradiation, a SCLC treatment (4,19), following chemotherapy demonstrated that low-NLR patients who received prophylactic cranial irradiation (n=6) had a longer PFS than those who did not (n=28; 9.00±1.16 vs. 5.00±0.60 months; P= 0.039; Fig. 3E).…”

Section: Association Between Nlr Cranial Radiotherapy and Pfsmentioning

confidence: 99%

Cisplatin or carboplatin? Neutrophil to lymphocyte ratio may serve as a useful factor in small cell lung cancer therapy selection

et al. 2019

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The present study aimed to investigate the significance of the neutrophil to lymphocyte ratio (NLR) in peripheral blood of patients with small cell lung cancer (SCLC) when selecting a first-line treatment. A total of 73 patients with SCLC who had complete clinical data and sought treatment at Fujian Medical University Union Hospital between January 2014 and May 2016 were included. Data were retrospectively analyzed, utilizing a receiver operating characteristic curve to determine the NLR cut-off value. Out of the 73 patients, 39 were classified as high-NLR (NLR ≥3.80) and 34 as low-NLR (NLR <3.80). Compared with the high-NLR group, patients in the low-NLR group had a longer progression free survival (PFS); however, there was no statistically significant difference in overall survival (OS) time. Patients with a high NLR had a significantly longer PFS (P= 0.021) and OS time (P= 0.042) when treated with a etoposide/cisplatin (EP) therapy regimen, compared with those treated with etoposide/carboplatin (EC). PFS was the longest in the high-NLR patients with limited stage (LS; P= 0.002). Among the patients receiving the EC regimen, the PFS of the low-NLR group was significantly longer compared with the high-NLR group (P=0.003). Patients in the low-NLR group who received thoracic radiotherapy had a longer PFS (P= 0.011), when comparing patients in the low-NLR group who did not receive thoracic radiotherapy, and within this group the therapeutic effect of radiation was the greatest in LS patients. Compared with the high-NLR group, the low-NLR group patients who received cranial radiotherapy had a significantly longer PFS (P= 0.039). For the initial evaluation of patients with SCLC, pre-treatment NLR may be of significance for selecting first-line chemotherapy agents. As the present study was retrospective and investigated a limited number of patients, further research and prospective studies are warranted.

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Section: Association Between Nlr Cranial Radiotherapy and Pfsmentioning

confidence: 99%

Cisplatin or carboplatin? Neutrophil to lymphocyte ratio may serve as a useful factor in small cell lung cancer therapy selection

et al. 2019

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“…Since PCI not only produces a reduction in BM incidence but also provides an improvement in survival 5 , published guidelines always recommend PCI for both LD and ED patients who have a good response to initial treatment 6 7 . Yet, some patients still cannot avoid developing BM despite they have adopted PCI 4 8 9 10 . It remains unestablished that what factors cause some patients develop BM after PCI.…”

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confidence: 99%

Risk factors for brain metastases after prophylactic cranial irradiation in small cell lung cancer

Zeng

Xie

Meng

et al. 2017

Sci Rep

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Despite administration of prophylactic cranial irradiation (PCI), some small cell lung cancer (SCLC) patients still suffer from brain metastases (BM) with unknown risk factors. We conducted this study to identify patients with higher BM risk after PCI and improve their outcome. The characteristics and survival of all the SCLC patients underwent PCI in our institute from 2003 to 2014 were analyzed. Kaplan-Meier method was applied to estimate BM free survival (BMFS) and overall survival (OS). Cox regression analyses were performed to explore risk factors for BM. A total of 175 patients with the median age of 55 years (range, 29–76) were eligible, among whom 36 (20.6%) developed BM with median follow-up of 42 months. Both univariate and multivariate analyses showed HART and TNM classification (p < 0.05) were associated with BM. Two-stage system was not related with BMFS or OS (p > 0.05). Stage IIIB-IV and HART were independent risk factors for BM after PCI in SCLC. TNM classification was more valuable on prognosis than two-stage system. Further large-scale studies are needed to confirm our findings.

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“…Secondly, brain metastasis is one of the most important causes of treatment failure in patients with SCLC. Several randomized studies showed that PCI could reduce the rate of brain metastases in patients with SCLC who achieved CR . In these studies, the rates of brain metastases were from 42.0% to 67.1% in the patients who did not experience PCI and 11.0% to 40.0% in the patients who experienced PCI.…”

Section: Discussionmentioning

confidence: 99%

Long‐term survival for 93 months of limited‐stage small cell lung cancer: A case report and literature review

et al. 2014

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A 49-year-old man was diagnosed with small cell lung cancer in May 2005. Chemotherapy was started with 60 mg/day cisplatin iv drip (from days one to three), 2 mg topotecan (TP) hydrochloride iv drip (from days one to four), and traditional Chinese medicine (TCM) AiDi injection for anti-tumor. After four cycles, he underwent conformal radiotherapy with 56Gy/28 fractions in October 2005. In April 2006, a mass on the right supraclavicular area was found. Therefore, he underwent another course of radiotherapy. The fields included the right supraclavicular area and the radiation dose was 50Gy/25 fractions. After completion of chemoradiotherapy, the patient achieved complete remission. Subsequently, the patient received prophylactic cranial irradiation (PCI). Until April of 2012, he had been followed up regularly. Since the SCLC diagnosis, he had received TCM for seven years. In April 2012, the patient complained of coughing again. Subsequently, the patient was given five cycles of an etoposide carboplatin regimen. A computed tomography (CT) scan was performed for review, which showed no obvious change. The patient underwent a second-line chemotherapy irinotecan cisplatin three times. However, the symptoms and CT of this patient showed no significant improvement. We changed the chemotherapy regimen to TP (topotecan 1.2 mg iv drip, days one to five; carboplatin 100 mg iv drip, days one to five). After two TP regimens, the patient died in his sleep on 3 March 2013. In this case, the standardized sequential chemotherapy and radiotherapy treatment, PCI, TCM, and good compliance may have contributed to the patient's longer survival.

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Prophylactic cranial irradiation in small cell lung cancer: a single institution experience

Abstract: Our study demonstrated a low incidence of symptomatic brain metastases and favourable median PFS and OS in the patients that received PCI, when compared to published phase III data.

Cited by 5 publications

References 16 publications

Cisplatin or carboplatin? Neutrophil to lymphocyte ratio may serve as a useful factor in small cell lung cancer therapy selection

Cisplatin or carboplatin? Neutrophil to lymphocyte ratio may serve as a useful factor in small cell lung cancer therapy selection

Risk factors for brain metastases after prophylactic cranial irradiation in small cell lung cancer

Long‐term survival for 93 months of limited‐stage small cell lung cancer: A case report and literature review

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