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Prophylactic Cranial Irradiation

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https://www.readbyqxmd.com/read/28882584/prophylactic-cranial-irradiation-pci-vs-active-mri-surveillance-for-small-cell-lung-cancer-the-case-for-equipoise
#1
REVIEW
Chad G Rusthoven, Brian D Kavanagh
Prophylactic cranial irradiation (PCI) for small-cell lung cancer (SCLC) offers a consistent reduction in the incidence of brain metastases (BM), at the cost of measurable toxicity to neurocognitive function and quality of life in the setting of characteristic pathologic changes to the brain. The sequelae of PCI have historically been justified by the perception of an overall survival (OS) advantage specific to SCLC. This rationale has now been challenged by a randomized trial in extensive-stage SCLC demonstrating equivalent progression-free survival and a trend toward improved OS with PCI omission in the context of modern MRI staging, surveillance, and salvage therapy...
September 4, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28860809/perihippocampal-metastasis-following-hippocampus-avoiding-prophylactic-cranial-irradiation-for-small-cell-lung-cancer-a-case-report
#2
Seung-Gu Yeo
Prophylactic cranial irradiation (PCI) lowers the risk of brain metastasis (BM) and increases survival in small cell lung cancer (SCLC) patients, but it also entails a risk of neurocognitive dysfunction (NCD). One strategy to mitigate this neurotoxicity is hippocampus-avoiding (HA) whole-brain radiation therapy, as the hippocampus is mainly responsible for radiation-related NCD and hippocampal or perihippocampal metastases are rare. A few prospective clinical trials have demonstrated a reduction in NCD following HA whole-brain radiation therapy...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28854622/prophylactic-cranial-irradiation-in-patients-with-extensive-stage-small-cell-lung-cancer
#3
Ayal A Aizer, Raymond Mak, Brian M Alexander
No abstract text is available yet for this article.
August 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28840978/phase-ii-study-of-celecoxib-with-docetaxel-chemoradiotherapy-followed-by-consolidation-chemotherapy-docetaxel-plus-cisplatin-with-maintenance-celecoxib-in-inoperable-stage-iii-nonsmall-cell-lung-cancer
#4
Harminder Takhar, Nimit Singhal, Anna Mislang, Raj Kumar, Laurence Kim, Sid Selva-Nayagam, Ken Pittman, Chris Karapetis, Martin Borg, Ian N Olver, Michael P Brown
TITLE: Phase II study of celecoxib with docetaxel chemoradiotherapy (CRT) followed by consolidation chemotherapy docetaxel plus cisplatin with maintenance celecoxib in inoperable stage III nonsmall cell lung cancer. INTRODUCTION: Concurrent CRT has been associated with improvement in absolute 5-year survival by 10% and is the standard of care for inoperable stage III nonsmall cell lung cancer. Preclinical evidence suggests that cyclooxygenase-2 inhibition may increase the efficacy of CRT...
August 25, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28822604/volumetric-modulated-arc-therapy-vmat-for-whole-brain-radiotherapy-not-only-for-hippocampal-sparing-but-also-for-reduction-of-dose-to-organs-at-risk
#5
Sumit Sood, Damodar Pokhrel, Christopher McClinton, Christopher Lominska, Rajeev Badkul, Hongyu Jiang, Fen Wang
A prospective clinical trial, Radiation Therapy Oncology Group (RTOG) 0933, has demonstrated that whole brain radiotherapy (WBRT) using conformal radiation delivery technique with hippocampal avoidance is associated with less memory complications. Further sparing of other organs at risk (OARs) including the scalp, ear canals, cochleae, and parotid glands could be associated with reductions in additional toxicities for patients treated with WBRT. We investigated the feasibility of WBRT using volumetric-modulated arc therapy (VMAT) to spare the hippocampi and the aforementioned OARs...
August 16, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
https://www.readbyqxmd.com/read/28816157/prophylactic-cranial-irradiation-for-small-cell-lung-cancer-new-insights
#6
Megan E Daly, David A Palma
No abstract text is available yet for this article.
September 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28798808/altered-brain-functional-connectivity-in-small-cell-lung-cancer-patients-after-chemotherapy-treatment-a-resting-state-fmri-study
#7
Konstantinos Bromis, Kostakis Gkiatis, Irene Karanasiou, George Matsopoulos, Eustratios Karavasilis, Matilda Papathanasiou, Efstathios Efstathopoulos, Nikolaos Kelekis, Vasileios Kouloulias
Previous studies in small-cell lung cancer (SCLC) patients have mainly focused on exploring neurocognitive deficits associated with prophylactic cranial irradiation (PCI). Little is known about functional brain alterations that might occur due to chemotherapy treatment in this population before PCI is administered. For this reason, we used resting-state functional Magnetic Resonance Imaging (fMRI) to examine potential functional connectivity disruptions in brain networks, including the Default Mode Network (DMN), the Sensorimotor Network, and the Task-Positive Network (TPN)...
2017: Computational and Mathematical Methods in Medicine
https://www.readbyqxmd.com/read/28797998/the-effect-of-dose-volume-parameters-on-central-nervous-system-relapse-in-pediatric-patients-with-acute-leukemia-receiving-prophylactic-cranial-irradiation
#8
Zeliha Guzeloz, Ayse Nur Demiral, Fatma Eren, Mehmet Adigul, Ahmet Ergin Capar, Handan Cakmakci, Sebnem Yilmaz, Ozlem Tufekci, Hale Oren, Riza Çetingoz
AIM OF THE STUDY: To investigate the effects of dosevolume parameters of brain parenchyma, optic nerves (ONs) and cribriform plate (CP), which were determined on central nervous system (CNS) control in pediatric leukemia patients who have undergone prophylactic cranial irradiation (PCI) at our department. PATIENTS AND METHODS: In the current study, the records of 14 patients were examined retrospectively. Along with the minimum and maximum doses for brain and CP, D95% (minimal dose received by the 95% volume of a structure) and V95% (percent volume of target receiving 95% of prescribed dose) could be obtained from the dose-volume histogram...
May 2017: Gulf Journal of Oncology
https://www.readbyqxmd.com/read/28709456/analyses-of-distribution-and-dosimetry-of-brain-metastases-in-small-cell-lung-cancer-with-relation-to-the-neural-stem-cell-regions-feasibility-of-sparing-the-hippocampus-in-prophylactic-cranial-irradiation
#9
Lei Zhao, Yan Shen, Jin-Dong Guo, Heng-Le Gu, Wen Yu, Jia-Ming Wang, Chang-Xing Lv, Jun Liu, Xu-Wei Cai, Xiao-Long Fu
BACKGROUND: This work aims to assess the feasibility of selectively sparing the hippocampus during prophylactic cranial irradiation (PCI) for small cell lung cancer (SCLC). METHODS: SCLC patients with brain metastases (BMs) diagnosed with MRI were enrolled. Lesions localized to the neural stem cell (NSC) compartments [subventricular zone (SVZ) or hippocampus] were analyzed. Patients were categorized by the total number of intracranial metastases, the therapy processes and the symptoms...
July 15, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28690012/prognostic-value-of-metabolic-parameters-of-metastatic-lymph-nodes-on-18-f-fdg-pet-ct-in-patients-with-limited-stage-small-cell-lung-cancer-with-lymph-node-involvement
#10
Feng Jin, Bo Qu, Zheng Fu, Yan Zhang, Anqin Han, Li Kong, Jinming Yu
INTRODUCTION: We assessed the prognostic value of the metabolic parameters of different lesions, including primary tumors and metastatic lymph nodes (LNs), measured by fluorine-18 fluorodeoxyglucose positron emission tomography (PET)/computed tomography in patients with limited-stage small-cell lung cancer (LS-SCLC) with LN metastasis. MATERIALS AND METHODS: The present retrospective study included 46 patients with clinical stage II-III N1-N2 LS-SCLC who had undergone pretreatment fluorine-18 fluorodeoxyglucose PET/computed tomography scanning from January 2011 to December 2014...
June 22, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28662868/the-incidence-of-symptomatic-brain-metastases-from-extra-pulmonary-small-cell-carcinoma-is-there-a-role-for-prophylactic-cranial-irradiation-in-a-clinically-relevant-population-cohort
#11
Alex De Caluwé, Gale Bowering, Alan Nichol, Fred Hsu
BACKGROUND AND PURPOSE: To examine the incidence and outcomes of patients with brain metastases from extra-pulmonary small cell carcinoma (EPSCC) and assess the indication for prophylactic cranial irradiation (PCI). MATERIALS AND METHODS: A Provincial cancer registry was used to conduct a retrospective, population-based study of patients diagnosed with EPSCC between January 1997 and December 2011. The primary end point was the incidence of brain metastases. The secondary endpoint was overall survival...
July 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28648948/randomized-phase-ii-study-comparing-prophylactic-cranial-irradiation-alone-to-prophylactic-cranial-irradiation-and-consolidative-extracranial-irradiation-for-extensive-disease-small-cell-lung-cancer-ed-sclc-nrg-oncology-rtog-0937
#12
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: NRG Oncology RTOG 0937 is a randomized phase II trial evaluating 1-year overall survival (OS) with prophylactic cranial irradiation (PCI) or PCI plus consolidative radiation therapy (PCI+cRT) to intrathoracic disease and extracranial metastases for extensive-disease SCLC. METHODS: Patients with one to four extracranial metastases were eligible after a complete response or partial response to chemotherapy. Randomization was to PCI or PCI+cRT to the thorax and metastases...
October 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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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