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Prophylactic Cranial Irradiation

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https://www.readbyqxmd.com/read/28648948/randomized-phase-ii-study-comparing-prophylactic-cranial-irradiation-alone-to-prophylactic-cranial-irradiation-and-consolidative-extra-cranial-irradiation-for-extensive-disease-small-cell-lung-cancer-ed-sclc-nrg-oncology-rtog-0937
#1
Elizabeth M Gore, Chen Hu, Alexander Y Sun, Daniel F Grimm, Suresh S Ramalingam, Neal E Dunlap, Kristin A Higgins, Maria Werner-Wasik, Aaron M Allen, Puneeth Iyengar, Gregory M M Videtic, Russell K Hales, Ronald C McGarry, James J Urbanic, Anthony T Pu, Candice A Johnstone, Volker W Stieber, Rebecca Paulus, Jeffrey D Bradley
INTRODUCTION: RTOG-0937 is a randomized phase-II trial evaluating 1-year OS with PCI or PCI plus consolidative radiation therapy (cRT) to intra-thoracic disease and extracranial metastases for ED-SCLC. METHODS: Patients with 1-4 extracranial metastases were eligible after CR or PR to chemotherapy. Randomization was to PCI or PCI+cRT to the thorax and metastases. Original stratification included PR vs CR after chemotherapy and 1 vs 2-4 metastases; age < 65 vs > 65 was added after an observed imbalance...
June 22, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28638799/bilateral-diffuse-grade-5-radiation-pneumonitis-after-intensity-modulated-radiation-therapy-for-localized-lung-cancer
#2
Virginia W Osborn, Andrea Leaf, Anna Lee, Elizabeth Garay, Joseph Safdieh, David Schwartz, David Schreiber
We are reporting a case of fatal radiation pneumonitis that developed six months following chemoradiation for limited stage small cell lung cancer. The patient was a 67-year-old man with a past medical history of Hashimoto's thyroiditis and remote suspicion for CREST, neither of which were active in the years leading up to treatment. He received 6600 cGy delivered in 200 cGy daily fractions via intensity modulated radiation therapy with concurrent cisplatin/etoposide followed by additional chemotherapy with dose-reduced cisplatin/etoposide and carboplatin/etoposide and then received prophylactic cranial irradiation...
June 10, 2017: World Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28625628/which-patients-with-es-sclc-are-most-likely-to-benefit-from-more-aggressive-radiotherapy-a-secondary-analysis-of-the-phase-iii-crest-trial
#3
Ben J Slotman, Corinne Faivre-Finn, Harm van Tinteren, Astrid Keijser, John Praag, Joost Knegjens, Matthew Hatton, Iris van Dam, Annija van der Leest, Bart Reymen, Jos Stigt, Kate Haslett, Devashish Tripathi, Egbert F Smit, Suresh Senan
INTRODUCTION: In ES-SCLC patients with residual intrathoracic disease after first-line chemotherapy, the addition of thoracic radiotherapy reduces the risk of intrathoracic recurrence, and improves 2-year survival. To identify patient subgroups for future trials investigating higher dose (extra)thoracic radiotherapy, we investigated the prognostic importance of number and sites of metastases in patients included in the CREST trial. MATERIALS/ METHODS: Additional data on sites and numbers of metastases were collected from individual records of 260 patients from the top 9 recruiting centers in the randomized CREST trial (53% of 495 study patients), which compared thoracic radiotherapy (TRT) to no TRT in ES-SCLC patients after any response to chemotherapy...
June 2017: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
https://www.readbyqxmd.com/read/28587038/hippocampal-avoidance-prophylactic-cranial-irradiation-in-small-cell-lung-carcinoma
#4
N Aherne, D Tune, A Ross, P Dwyer, A Last
No abstract text is available yet for this article.
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28586977/impact-of-prophylactic-cranial-irradiation-on-overall-survival-in-metastatic-small-cell-lung-cancer-a-propensity-score-matched-analysis-of-patients-in-the-national-cancer-database
#5
S Sharma, M McMillan, A Doucette, R Cohen, C B Simone, J E Shabason
No abstract text is available yet for this article.
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28581402/prophylactic-cranial-irradiation-in-resected-early-stage-small-cell-lung-cancer
#6
Chukwuka Eze, Olarn Roengvoraphoj, Farkhad Manapov
No abstract text is available yet for this article.
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28581401/prospective-study-of-hippocampal-sparing-prophylactic-cranial-irradiation-in-limited-stage-small-cell-lung-cancer
#7
Kristin J Redmond, Russell K Hales, Heather Anderson-Keightly, Xian C Zhou, Megan Kummerlowe, Haris I Sair, Mario Duhon, Lawrence Kleinberg, Gary L Rosner, Tracy Vannorsdall
PURPOSE: To prospectively evaluate cognitive function and intracranial failure patterns after hippocampal-sparing prophylactic cranial irradiation (PCI) for limited-stage small cell lung cancer (SCLC). METHODS AND MATERIALS: Adults with limited-stage SCLC, achieving a complete response to chemoradiotherapy and no brain metastases, were eligible. Patients received PCI 25 Gy/10 fractions, with a mean hippocampal dose limited to <8 Gy and ≥90% of the brain receiving 90% of the prescription...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28535095/managing-cns-disease-in-adults-with-acute-lymphoblastic-leukemia
#8
Richard A Larson
The central nervous system (CNS) is an important site of involvement by acute lymphoblastic leukemia (ALL) in adults. The prevalence is sufficiently high that prophylactic treatment is routinely given to this sanctuary site in order to eradicate occult disease that might otherwise lead to a relapse. A lumbar puncture should be routinely performed in all newly diagnosed patients with ALL. The risks of CNS leukemia vary by phenotype and genotype. Preventive treatment of the CNS during post-remission therapy has become an integral part of all current ALL treatment protocols...
May 23, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28469334/clinical-profile-of-pediatric-oncology-patients-treated-by-external-beam-radiotherapy-an-institutional-experience
#9
Virender Suhag, B S Sunita, Pankaj Vats, Arti Sarin, A K Singh, Mayuri Jain
INTRODUCTION: Pediatric tumors are a heterogeneous group of malignant conditions requiring multimodal treatment, and management of such cases is at time challenging. We present the clinical profile of pediatric cancer patients who received radiation, either alone or as adjuvant to surgery and chemotherapy; in prophylactic, radical or palliative clinical setting. AIM: This study was envisaged to review our experience of pediatric oncology cases, their clinical and morphological profile, dosage schedule of radiotherapy, and the therapy induced complications...
January 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/28457584/prophylactic-lower-para-aortic-irradiation-using-intensity-modulated-radiotherapy-mitigates-the-risk-of-para-aortic-recurrence-in-locally-advanced-cervical-cancer-a-10-year-institutional-experience
#10
Jie Lee, Jhen-Bin Lin, Chih-Long Chang, Ya-Ting Jan, Fang-Ju Sun, Meng-Hao Wu, Yu-Jen Chen
OBJECTIVE: To evaluate the effects of prophylactic sub-renal vein radiotherapy (SRVRT) using intensity-modulated radiotherapy (IMRT) for cervical cancer. METHODS: A total of 206 patients with FIGO stage IB2-IVA cervical cancer and negative para-aortic lymph nodes (PALNs) who underwent pelvic IMRT (PRT) or SRVRT between 2004 and 2013 at our institution were reviewed. SRVRT cranially extended the PRT field for PALNs up to the left renal vein level. The prescribed dose was consistent 50...
July 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28447257/recent-developments-in-radiotherapy-for-small-cell-lung-cancer-a-review-by-the-oncologic-group-for-the-study-of-lung-cancer-spanish-radiation-oncology-society
#11
REVIEW
N Rodriguez de Dios, P Calvo, M Rico, M Martín, F Couñago, A Sotoca, B Taboada, A Rodríguez
Small-cell lung cancer (SCLC) accounts for 13% of all lung tumours. The standard treatment in patients with limited-stage disease is radiotherapy combined with chemotherapy. In extensive SCLC, the importance of consolidation thoracic radiotherapy in patients with a good treatment response has become increasingly recognized. In both limited and extensive disease, prophylactic cranial irradiation is recommended in patients who respond to treatment. New therapeutic approaches such as immunotherapy are being increasingly incorporated into the treatment of SCLC, although more slowly than in non-small cell lung cancer (NSCLC)...
April 26, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28429473/surgery-for-limited-stage-small-cell-lung-cancer
#12
REVIEW
Hayley Barnes, Katharine See, Stephen Barnett, Renée Manser
BACKGROUND: Current treatment guidelines for limited-stage small-cell lung cancer (SCLC) recommend concomitant platinum-based chemo-radiotherapy plus prophylactic cranial irradiation, based on the premise that SCLC disseminates early, and is chemosensitive. However, although there is usually a favourable initial response, relapse is common and the cure rate for limited-stage SCLC remains relatively poor. Some recent clinical practice guidelines have recommended surgery for stage 1 (limited) SCLC followed by adjuvant chemotherapy, but this recommendation is largely based on the findings of observational studies...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28408183/outcomes-of-stereotactic-body-radiotherapy-for-t1-t2n0-small-cell-carcinoma-according-to-addition-of-chemotherapy-and-prophylactic-cranial-irradiation-a-multicenter-analysis
#13
Vivek Verma, Charles B Simone, Pamela K Allen, Steven H Lin
BACKGROUND: Although T1-T2N0 non-small cell lung cancer can be managed with stereotactic body radiotherapy (SBRT) alone, this management has often been extrapolated to T1-T2N0 small cell lung cancer (SCLC). This secondary analysis of a multi-institutional cohort study investigated whether the addition of chemotherapy and prophylactic cranial irradiation (PCI) improved the outcomes for these patients. MATERIALS AND METHODS: All cases of histologically confirmed T1-T2N0M0 SCLC were obtained from 24 institutions' prospectively collected SBRT databases...
March 16, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28391424/optimal-radiation-therapy-for-small-cell-lung-cancer
#14
REVIEW
Michael F Gensheimer, Billy W Loo
Radiation therapy plays an important role in the management of both limited stage and extensive stage small cell lung cancer. For limited stage disease, there has been a trend toward reduced size of thoracic radiation fields, which has the potential to reduce toxicity. FDG-PET staging helps make this possible by more accurately identifying areas of nodal and metastatic involvement. Trials have demonstrated similar outcomes using a range of radiation fractionation schedules, allowing flexibility in individualizing treatment...
April 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28382303/evaluation-of-the-efficacy-of-cisplatin-etoposide-and-the-role-of-thoracic-radiotherapy-and-prophylactic-cranial-irradiation-in-lcnec
#15
Arsela Prelaj, Sara Elena Rebuzzi, Gabriella Del Bene, Julio Rodrigo Giròn Berrìos, Alessandra Emiliani, Lucilla De Filippis, Alessandra Anna Prete, Silvia Pecorari, Gaia Manna, Carla Ferrara, Daniele Rossini, Flavia Longo
In small-cell lung cancer (SCLC), the role of chemotherapy and radiotherapy is well established. Large-cell neuroendocrine carcinoma (LCNEC) shares several clinicopathological features with SCLC, but its optimal therapy is not defined. We evaluated clinical response and survival outcomes of advanced LCNEC treated in first-line therapy compared with SCLC. 72 patients with stage III-IV LCNEC (n=28) and extensive-stage SCLC (ES-SCLC) (n=44) received cisplatin-etoposide with/without thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI)...
January 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28343976/prophylactic-cranial-irradiation-versus-observation-in-patients-with-extensive-disease-small-cell-lung-cancer-a-multicentre-randomised-open-label-phase-3-trial
#16
Toshiaki Takahashi, Takeharu Yamanaka, Takashi Seto, Hideyuki Harada, Hiroshi Nokihara, Hideo Saka, Makoto Nishio, Hiroyasu Kaneda, Koichi Takayama, Osamu Ishimoto, Koji Takeda, Hiroshige Yoshioka, Motoko Tachihara, Hiroshi Sakai, Koichi Goto, Nobuyuki Yamamoto
BACKGROUND: Results from a previous phase 3 study suggested that prophylactic cranial irradiation reduces the incidence of symptomatic brain metastases and prolongs overall survival compared with no prophylactic cranial irradiation in patients with extensive-disease small-cell lung cancer. However, because of the absence of brain imaging before enrolment and variations in chemotherapeutic regimens and irradiation doses, concerns have been raised about these findings. We did a phase 3 trial to reassess the efficacy of prophylactic cranial irradiation in the treatment of extensive-disease small-cell lung cancer...
March 23, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28343972/time-to-reconsider-prophylactic-cranial-irradiation-in-extensive-stage-small-cell-lung-cancer
#17
Ben J Slotman
No abstract text is available yet for this article.
May 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28340924/hippocampal-sparing-whole-brain-radiotherapy-for-lung-cancer
#18
REVIEW
Ren Zhao, Wei Kong, Jun Shang, Hong Zhe, Yan-Yang Wang
Brain metastases occur in 20% to 40% of lung cancer patients. Whole-brain radiotherapy (WBRT) has long been considered the treatment of choice for many patients with lung cancer, because of its wide availability, ease of delivery, and effectiveness in prolonging survival. However, WBRT is also associated with several side effects, such as decline in memory and other cognitive functions. There exists significant preclinical and clinical evidence that radiation-induced injury to the hippocampus correlates with neurocognitive decline of patients who receive WBRT...
March 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28326834/thoracic-radiation-therapy-could-give-survival-benefit-to-elderly-patients-with-extensive-stage-small-cell-lung-cancer
#19
Changchun An, Wang Jing, Yan Zhang, Sujing Liu, Haiyong Wang, Kunli Zhu, Li Kong, Hongbo Guo, Hui Zhu
AIM: To evaluate the effect of thoracic radiation therapy (TRT) in elderly patients (aged ≥65 years) with extensive-stage small-cell lung cancer (ES-SCLC). PATIENTS & METHODS: This study reviewed the records of 118 elderly patients with ES-SCLC (all with distant metastasis) through January 2006-December 2013. The patients were divided into either a chemotherapy (ChT)/TRT-combination group or a ChT-alone group. RESULTS: The median survival time and 3-year overall survival rates in the ChT/TRT group were significantly higher than those in the ChT-alone group (17...
February 24, 2017: Future Oncology
https://www.readbyqxmd.com/read/28325618/thoracic-irradiation-in-3weeks-for-limited-stage-small-cell-lung-cancer-is-twice-a-day-fractionation-really-needed
#20
REVIEW
G A Turgeon, L Souhami, N Kopek, V Hirsh, L Ofiara, S L Faria
PURPOSE: Many Canadian institutions treat limited-disease small cell lung cancer with 40Gy in 15 fractions delivered once-a-day in 3weeks concomitantly with chemotherapy. This regimen is convenient and seems to be effective. Here, we report and compare with a literature review the outcomes of patients with limited-stage small cell lung cancer treated in our institution with this hypofractionated regimen. PATIENTS AND METHODS: From January 2004 to December 2012, patients with limited-stage small cell lung cancer treated curatively with platinum-based chemotherapy and concurrent thoracic radiotherapy at a dose of 40Gy in 16 fractions once-a-day were eligible for this review...
April 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
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