Prophylactic cranial irradiation in small cell lung cancer.
Prophylatic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC) is a treatment under evaluation for about 30 years. Since the first randomized trials, it was clear that its use significantly decreased the brain metastasis rate. However, its effect on overall survival was not demonstrated. Retrospective reviews suggested that PCI could induce late neurologic damage. In recent years, two large randomized trials did not confirm this deleterious effect and even suggested a beneficial effect on survival. A recent meta-analysis including almost 1,000 randomized patients confirmed an improvement in overall survival. We discuss here the different aspects of this preventive treatment in a potentially curable disease.
Vinés
Eugenio F
EF
Instituto de Radiomedicina (IRAM), Santiago, Chile.
Le Péchoux
Cécile
C
Arriagada
Rodrigo
R
D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary*; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000532:radiotherapy* / Q000556:secondary*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy*; D015201:Meta-Analysis as Topic; D009483:Neuropsychological Tests; D016032:Randomized Controlled Trials as Topic; D012306:Risk