title: Treatment outcomes of patients with small cell lung cancer without prophylactic cranial irradiation.
abstract: BACKGROUND
  Prophylactic cranial irradiation (PCI) is indicated for limited disease (LD) in small cell lung cancer (SCLC) patients who achieve a complete or near-complete response; however, it is sometimes not administered because of possible adverse reactions or patient refusal. Here we assessed treatment outcomes among patients with SCLC who were not treated with PCI.
  
  
  METHODS
  The medical records of 60 patients (45 men, 15 women; mean age, 68 years; age range, 51-82 years) with SCLC were retrospectively reviewed. The tumors were staged by TNM classification. Two, 2, 5, 4, 32, and 15 patients had stage IA, IB, IIA, IIB, IIIA, and IIIB tumors, respectively. The patients were treated with thoracic radiotherapy (TRT) and four courses of chemotherapy.
  
  
  RESULTS
  Our subjects had a median survival of 25 months and 2- and 5-year survival rates of 52.6% and 25.3%, respectively. Univariate analysis revealed that the development of brain metastasis, performance status (PS), and T-stage were significant factors correlated with survival rate. Multivariate analysis identified only PS [hazard ratio (HR), 5.845, 95% confidence interval (CI), 2.333-14.63, P=0.002] and brain metastasis as independent prognostic variables (HR, 2.344, 95% CI, 1.071-5.128, P=0.033).
  
  
  CONCLUSIONS
  The results of our study demonstrated that the outcomes of treatment without PCI were improved, as compared with those of previously published data. Our findings may be used as reference data when PCI cannot be performed.
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Masakuni
authors.initials: M
authors.lastname: Sakaguchi
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Maebayashi
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Aizawa
authors.affiliation: Department of Radiology, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Naoya
authors.initials: N
authors.lastname: Ishibashi
authors.affiliation: Sonodakai Radiation Oncology Clinic, Tokyo, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Saito
keywords: Prophylactic cranial irradiation (PCI); small cell lung cancer (SCLC); thoracic radiotherapy (TRT)