title: Prophylactic cranial irradiation: recent outcomes and innovations.
abstract: Brain metastases represent a frequent problem in several malignancies. They can shorten survival while causing significant morbidity and impairment in the patient's quality of life. Prophylactic cranial irradiation (PCI) has become an integral part of the standard of care in small cell lung cancer (SCLC), yet its role in other malignancies remains the subject of significant discussion. Its role has been extensively investigated in non-small cell lung cancer and less so for breast cancer and other malignancies. Improvements in medical care as well as in whole brain radiotherapy (WBRT) techniques may improve the risk-benefit ratio of this therapy so as to expand its role in cancer care. The use of memantine in WBRT patients as well as the use of hippocampal avoidance techniques are of particular interest in this effort. Herein, we review the history of PCI, its current use, and areas of investigation in the application of PCI.
authors: 22 South Greene Street, Department of Radiation Oncology, Baltimore, MD 21201, USA.
authors: James W
authors: JW
authors: Snider
authors: Vinai
authors: V
authors: Gondi
authors: Paul D
authors: PD
authors: Brown
authors: Wolfgang
authors: W
authors: Tome
authors: Minesh P
authors: MP
authors: Mehta
mesh_terms: D001932:Brain Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000556:secondary*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology; D016371:Cranial Irradiation / Q000009:adverse effects; D006801:Humans; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D055752:Small Cell Lung Carcinoma / Q000473:pathology
keywords: brain metastasis; non-small-cell lung cancer; prophylactic cranial irradiation; small cell lung cancer; whole brain radiation therapy