Thirty years of prophylactic cranial irradiation in patients with small cell lung cancer: a meta-analysis of randomized clinical trials.
OBJECTIVE
To determine the role of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC).


METHODS
We searched various databases, selecting randomized clinical trials published in journals or conference proceedings within the last 30 years and investigating the role of PCI in the mortality of patients with SCLC, submitted to PCI or not.


RESULTS
Sixteen randomized clinical trials, collectively involving 1,983 patients, were considered eligible for inclusion. Of those 1,983 patients, 1,021 were submitted to PCI and 962 were not. Overall mortality was 4.4% lower in the patients submitted to PCI than in those who were not (OR = 0.73; 95% CI: 0.57-0.97; p = 0.01), especially among the patients showing a complete response after induction chemotherapy (OR = 0.68; 95% CI: 0.50-0.93; p = 0.02) and in those submitted to PCI after that treatment (OR = 0.68; 95% CI: 0.49-0.94; p = 0.03). That decrease did not correlate with the stage of the disease: limited disease (OR = 0.73; 95% CI: 0.55-0.97; p = 0.03); and extensive disease (OR = 0.48; 95% CI: 0.26-0.87; p = 0.02).


CONCLUSIONS
Our findings suggest that PCI decreases mortality in patients with SCLC, especially in those showing a complete response after induction chemotherapy and in those submitted to PCI after that treatment, regardless of the stage of the disease.
Departamento de Radioterapia e Oncologia, Faculdade de Medicina de Marília, Marília, SP, Brazil. gusviani@gmail.com
Gustavo Arruda
GA
Viani
André Campiolo
AC
Boin
Veridiana Yuri
VY
Ikeda
Bruno Silveira
BS
Vianna
Rondinelli Salvador
RS
Silva
Fernando
F
Santanella
D001932:Brain Neoplasms / Q000517:prevention & control*; D016371:Cranial Irradiation / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D060828:Induction Chemotherapy / Q000401:mortality; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D016032:Randomized Controlled Trials as Topic; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy