Cranial prophylactic irradiation in locally advanced non-small cell lung carcinoma: current status and future perspectives.
As a result of improved local and regional control with aggressive multimodality protocols, the brain has become one of the major sites of relapse in patients with locally advanced non-small cell lung carcinoma (LA-NSCLC). The demonstrated efficacy of prophylactic cranial irradiation (PCI) in small-cell lung carcinoma led to studies of its effectiveness in LA-NSCLC, which indicated that PCI also has a high potential to reduce the incidence or delay the occurrence of brain metastases in this patient group. This report provides an extensive review of the current evidence from nonrandomized and randomized trials regarding the use of PCI in LA-NSCLC and discusses related key issues including risk factors, patient selection criteria, timing of PCI, preferred PCI dosing scheme, toxicity profile and potential novel PCI techniques.
Topkan
Erkan
E
Department of Radiation Oncology, Baskent University School of Medicine, Adana, Turkey. drerkantopkan@yahoo.com
Yildirim
Berna Akkus
BA
Selek
Ugur
U
Yavuz
Melek Nur
MN
D001932:Brain Neoplasms / Q000517:prevention & control* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D003071:Cognition / Q000528:radiation effects; D016371:Cranial Irradiation / Q000009:adverse effects; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D013909:Thorax / Q000528:radiation effects; D013997:Time Factors