Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small cell lung cancer.
BACKGROUND
In non-small cell lung cancer (NSCLC), there is a relatively high incidence of brain metastases following radical treatment. At present, the role of prophylactic cranial irradiation (PCI) in this group of patients is not clear.


OBJECTIVE
To investigate whether PCI has a role in the management of patients with NSCLC treated with radical intent.


METHODS
The electronic databases MEDLINE, EMBASE and Cancerlit, along with handsearching of journals, relevant books, and review articles used to identify potentially eligible trials.


METHODS
Randomised controlled trials (RCTs) comparing PCI with no PCI in NSCLC patients treated with radical intent.


METHODS
Four RCTs were reviewed. Due to the small patient numbers, and variations in radiotherapy (RT) dose, no meta-analysis was attempted.


RESULTS
PCI may reduce the incidence of brain metastases, but there is no evidence of a survival benefit. There is no evidence that any regimen is superior, and the effect of PCI on quality of life (QOL) is not known.


CONCLUSIONS
There is insufficient evidence to support the use of PCI in clinical practice. Where possible, patients should be offered entry into a clinical trial.
Lester
J F
JF
Radiotherapy Department, Velindre Hospital, Whitchurch, Cardiff, Wales, UK, CF14 7XL. jason.lester@velindre-tr.wales.nhs.uk
Coles
B
B
Macbeth
F R
FR
D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000517:prevention & control* / Q000556:secondary; D016371:Cranial Irradiation; D006801:Humans; D008175:Lung Neoplasms; D016032:Randomized Controlled Trials as Topic