Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission.

@article{Arriagada1995ProphylacticCI,
  title={Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission.},
  author={Rodrigo Arriagada and Thierry le Chevalier and Francoise Borie and Alain Rivi{\`e}re and P. Chomy and Isabelle Monnet and Anne A Tardivon and Fausto Viader and Mich{\`e}le Tarayre and Simone Benhamou},
  journal={Journal of the National Cancer Institute},
  year={1995},
  volume={87 3},
  pages={
          183-90
        }
}
BACKGROUND Prophylactic cranial irradiation in patients with small-cell lung cancer decreases the overall rate of brain metastases without an effect on overall survival. It has been suggested that this treatment may increase neuropsychological syndromes and brain abnormalities indicated by computed tomography scans. However, other retrospective data suggested a beneficial effect on overall survival for patients in complete remission. PURPOSE Our purpose was to evaluate the effects of… Expand
Prophylactic cranial irradiation in extensive small-cell lung cancer.
TLDR
Prophylactic cranial irradiation reduces the incidence of symptomatic brain metastases and prolongs disease-free and overall survival and did not have a clinically significant effect on global health status. Expand
Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group.
TLDR
Prophylactic cranial irradiation improves both overall survival and disease-free survival among patients with small-cell lung cancer in complete remission and identifies a trend toward a decrease in the risk of brain metastasis with earlier administration of cranials irradiation after the initiation of induction chemotherapy. Expand
Prophylactic cranial irradiation for patients with lung cancer.
TLDR
Findings from randomised controlled trials and a meta-analysis have shown that prophylactic cranial irradiation not only reduces the incidence of brain metastases in patients with SCLC and with non-metastatic NSCLC, but also improves overall survival in patients who respond to first-line treatment. Expand
Outcome in patients with small cell lung cancer re-irradiated for brain metastases after prior prophylactic cranial irradiation.
TLDR
Cerebral re-irradiation after prior PCI is beneficial for symptom palliation and is associated with minimal side effects in patients with SCLC, and survival data suggests that it is primarily useful in Patients with adequate performance status. Expand
Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial.
TLDR
Prophylactic cranial irradiation is therefore not essential for patients with extensive-disease small-cell lung cancer with any response to initial chemotherapy and a confirmed absence of brain metastases when patients receive periodic MRI examination during follow-up. Expand
Prophylactic Cranial Irradiation in Extensive Stage Small Cell Lung Cancer: Outcomes at a Comprehensive Cancer Centre.
TLDR
PCI in the setting of at least a partial response to chemotherapy was found to have a survival benefit and prolongation of the time to development of brain metastases, when factoring in the use of initial postchemotherapy but not routine surveillance brain imaging. Expand
Prophylactic cranial irradiation in small-cell lung cancer.
TLDR
Several additional sources of information can be drawn together to suggest a dose-response pattern for prophylactic brain irradiation, leading to the recommendation that a dose of 25-36 Gy is optimal, delivered in 2-3 Gy daily fractions after the completion of chest irradiation and chemotherapy. Expand
Prophylactic cranial irradiation in small-cell lung cancer: is it ever indicated?
Prophylactic cranial irradiation (PCI) is being reintroduced into multimodality treatment protocols of patients with small-cell lung cancer (SCLC). The history of its use brings interesting insightsExpand
Prophylactic cranial irradiation could improve overall survival in patients with extensive small cell lung cancer
TLDR
PCI after any response to initial chemotherapy significantly improved overall survival (OS) in patients with extensive small cell lung cancer (ESCLC). Expand
Prophylactic Cranial Irradiation for Extensive-Stage Small-Cell Lung Cancer: A Retrospective Analysis
TLDR
Careful patient selection for PCI can improve not only brain metastases control and higher second-line chemotherapy exposure and higher patient survival but also patient survival. Expand
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References

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Follow-up neurological evaluation in patients with small cell lung carcinoma treated with prophylactic cranial irradiation and chemotherapy.
TLDR
This group of patients is a unique cohort: adults who have received cranial irradiation in the absence of known brain tumor with long term follow-up and the lack of clinically significant changes would suggest no contraindication to PCI when indicated. Expand
Role of prophylactic cranial irradiation in prevention of central nervous system metastases in small cell lung cancer. Potential benefit restricted to patients with complete response.
TLDR
Prophylactic cranial irradiation had no influence on leptomeningeal, spinal, or epidural metastases, but a significant reduction in intracerebral metastases was observed and there was a statistically significant improvement in overall survival. Expand
Value of prophylactic cranial irradiation given at complete remission in small cell lung carcinoma.
TLDR
PCI at CR confers effective and worthwhile local control in the CNS, especially during periods of systemic response, and a small percentage of patients may benefit. Expand
Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: Results of a multicentre randomised trial
TLDR
In both groups, there was impairment of cognitive function and QoL before PCI and additional impairment at 6 months and 1 year, but no consistent difference between the two groups and thus no evidence over 1 year of major impairment attributable to PCI. Expand
Comparative study of prophylactic cranial irradiation in patients with small cell lung cancer achieving a complete response: a long-term follow-up result.
TLDR
The results appear to warrant further clinical trials to clarify the utility of prophylactic cranial irradiation in patients with SCLC achieving a complete response. Expand
Low dose elective brain irradiation in small cell carcinoma of the lung.
Abstract Elective brain irradiation (EBI) in a dosage of 3000 rad (midplane) in 2 weeks (nominal standard dose (NSD) = 1314 ret) has proven highly effective in preventing initial brain relapse inExpand
Prophylactic cranial irradiation in small cell carcinoma of the lung. A randomized study.
TLDR
Although PCI did not improve response rate or survival, brain metastasis with its attendant neurologic complications was effectively prevented and was the cause of major neurologic disability in each. Expand
Thoracic and elective brain irradiation with concomitant or delayed multiagent chemotherapy in the treatment of localized small cell carcinoma of the lung: A randomized prospective study by the southeastern cancer study group
TLDR
The study emphasizes the need for intensive chemotherapy and adequate radiation therapy to improve survival of patients with small cell undifferentiated carcinoma of the lung and indicates the role of each modality in the management of these patients. Expand
The role of prophylactic cranial irradiation in the management of small cell lung cancer.
TLDR
The concept of the brain as a pharmacologic sanctuary site for metastases is inconsistent with newer clinical observations, and it is disputable what influence the presence of brain metastases per se, if actively influenced by systemic chemotherapy. Expand
Late neurological complications after prophylactic cranial irradiation in patients with small-cell lung cancer: the Toronto experience.
  • M. Lishner, R. Feld, +7 authors E. Maki
  • Medicine
  • Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • 1990
TLDR
It is concluded that the use of PCI in these doses was effective in reducing the frequency of CNS metastases and had an adverse effect on the daily life and well-being only in a minority of the patients. Expand
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