Long-term results of prophylactic cranial irradiation for limited-stage small-cell lung cancer in complete remission.
BACKGROUND
Brain metastasis is one of the most important causes of treatment failure in patients with small cell lung cancer (SCLC). This study was conducted to evaluate the effects of prophylactic cranial irradiation (PCI) on survival and brain metastases for patients with limited stage small cell lung cancer in complete remission.


METHODS
Fifty one patients with limited stage SCLC in complete remission after chemoradiotherapy were randomly divided into PCI group (n = 26) and control group (n = 25). Patients in the PCI group received PCI at a dose of 25.2 to 30.6 Gy in 1.8 to 2.0 Gy per fraction. The Kaplan-Meier method and Log rank test were used to analyse and compare survival rates, and chi(2) test was used to compare the incidences of cranial metastases in two groups.


RESULTS
There was no significant difference in clinical characteristics of patients such as age, sex, effect of treatment before PCI between the two groups. The incidence of brain metastases was 3.8% in the PCI group in contrast to 32.0% in the control group (chi(2) = 5.15, P = 0.02). The 1, 3, 5-year survival rates were 84.6%, 42.3%, 34.6% respectively in the PCI group and 72.0%, 32.0%, 24.0% respectively in the control group, with no difference between the two groups (chi(2) = 2.25, P = 0.13). No serious sequelae were observed in patients receiving PCI.


CONCLUSIONS
For patients with limited stage SCLC responding completely to chemotherapy plus radiotherapy, PCI can decrease the incidence of brain metastases and improve survival rate.
Cao
Ka-Jia
KJ
Department of Radiation Oncology, Cancer Centre, Sun Yat-sen University, Guangzhou 510060, China. caokajia@163.com
Huang
Hui-ying
HY
Tu
Ming-chi
MC
Pan
Guo-ying
GY
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D016371:Cranial Irradiation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged