medric medric
[닫기]
잠시만 기다려 주세요. 로딩중입니다.

The value of prophylactic cranial irradiation in limited-stage small cell lung cancer: should it always be recommended?

Radiation Oncology Journal 2019년 37권 3호 p.156 ~ 165
 ( Koh Min-Ji ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology

 ( Song Si-Yeol ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
 ( Jo Ji-Hwan ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
 ( Park Geum-Ju ) - Inje University Haeundae Paik Hospital Department of Radiation Oncology
 ( Park Jae-Won ) - Yeungnam University Medical Center Department of Radiation Oncology
 ( Kim Su-Ssan ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology
 ( Choi Eun-Kyung ) - University of Ulsan College of Medicine Asan Medical Center Department of Radiation Oncology

Abstract


Purpose: Prophylactic cranial irradiation (PCI) is a standard treatment for limited-stage small cell lung cancer (LS-SCLC) showing a response to initial treatment, but many patients do not receive PCI due to comorbidities or refusal. This study aims to define the patient group for whom PCI can be omitted with minimal risk.

Materials and Methods: Patients with LS-SCLC who underwent radiotherapy with curative aim at our institution between January 2004 and December 2015 were retrospectively reviewed. Patients who did not receive PCI were evaluated for brain metastasis-free survival (BMFS), progression-free survival (PFS), overall survival (OS), and prognostic factors for survival, and treatment outcomes were compared with a patient cohort who received PCI.

Results: A total of 350 patients achieved a response following thoracic radiotherapy, and 190 of these patients did not receive PCI. Stage I?II and a complete response (CR) to initial therapy were good prognostic factors for BMFS and OS on univariate analysis. Patients with both stage I?II and a CR who declined PCI showed comparable 2-year BMFS to those who received PCI (92% vs. 89%). In patients who achieved CR, PCI did not significantly improve OS or PFS.

Conclusion: There should be less concern about omitting PCI in patients with comorbidities if they have stage I?II or a CR, with brain metastasis control being comparable to those patients who receive PCI.

키워드

Small cell lung carcinoma; Radiotherapy; Prophylactic cranial irradiation; PCI; Brain; Complete remission
원문 및 링크아웃 정보
 
등재저널 정보