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Prophylactic Cranial Irradiation

Yin Ting Cheung, Wassim Chemaitilly, Daniel A Mulrooney, Tara M Brinkman, Wei Liu, Pia Banerjee, Deokumar Srivastava, Ching-Hon Pui, Leslie L Robison, Melissa M Hudson, Kevin R Krull
Long-term survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for neurocognitive impairment, as well as compromised hypothalamic-pituitary-adrenal (HPA) function. Dehydroepiandrosterone-sulfate (DHEAS) is an adrenal androgen commonly used as a marker of HPA function. In the general population, a low level of DHEAS has been associated with poorer cognition. At ≥2years post-treatment, we examined the association of DHEAS with attention outcomes in 35 male and 34 female long-term survivors of childhood ALL (mean[standard deviation] age at evaluation 14...
November 16, 2016: Psychoneuroendocrinology
Olarn Roengvoraphoj, Chukwuka Eze, Maximilian Niyazi, Minglun Li, Guido Hildebrandt, Rainer Fietkau, Claus Belka, Farkhad Manapov
BACKGROUND: Previous studies have demonstrated that female gender could be a prognostic factor in limited-disease (LD) small-cell lung cancer (SCLC), but the correlation between patient gender and survival parameters remains unclear. PATIENTS AND METHODS: Data from 179 LD SCLC patients treated with definitive chemoradiotherapy (CRT) were reviewed. Influence of patient gender on time to progression (TTP), local control (LC), brain metastasis-free (BMFS), distant metastasis-free (DMFS) and overall survival (OS) was analysed...
November 16, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Denise Bernhardt, Farastuk Bozorgmehr, Sebastian Adeberg, Nils Opfermann, Damian von Eiff, Juliane Rieber, Jutta Kappes, Robert Foerster, Laila König, Michael Thomas, Jürgen Debus, Martin Steins, Stefan Rieken
OBJECTIVES: Patients with brain metastases from small-cell lung cancer (SCLC) who underwent prior prophylactic cranial irradiation (PCI) are often treated with a second course of whole brain radiation therapy (Re-WBRT) or stereotactic radiosurgery (SRS) for purposes of palliation in symptomatic patients, hope for increased life expectancy or even as an alternative to untolerated steroids. Up to date there is only limited data available regarding the effect of this treatment. This study examines outcomes in patients in a single institution who underwent cerebral re-irradiation after prior PCI...
November 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Hye-Jin Kim, Chang-Min Choi, Seul-Gi Kim
BACKGROUND: Factors associated with the prognosis of patients with small cell lung cancer (SCLC) is relatively unknown, than of those with non-small cell lung cancer. This study was undertaken to identify the prognostic factors of SCLC. METHODS: The medical records of 333 patients diagnosed with SCLC at tertiary hospital from January 1, 2008, to December 31, 2012 were retrospectively reviewed. Patients were categorized by age (≤65 years vs. >65 years) and by extent of disease (limited disease [LD] vs extensive disease [ED])...
October 2016: Tuberculosis and Respiratory Diseases
Beata Sas-Korczyńska, Elżbieta Łuczyńska, Wojciech Kamzol, Andrzej Sokołowski
INTRODUCTION: The most effective therapy in patients with limited-stage small cell lung cancer (LS SCLC) seems to be chemotherapy (using platinum-based regimens) and thoracic radiotherapy (TRT), which is followed by prophylactic cranial irradiation. MATERIALS AND METHODS: The analysed group comprised 217 patients who received combined treatment for LS SCLC, i.e. chemotherapy (according to cisplatin and etoposide schedule) and TRT (concurrent in 101 and sequential in 116 patients)...
October 26, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Masakuni Sakaguchi, Toshiya Maebayashi, Takuya Aizawa, Naoya Ishibashi, Tsutomu Saito
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...
September 2016: Journal of Thoracic Disease
Gregory P Kalemkerian
Small cell lung cancer (SCLC) is a high-grade neuroendocrine tumor characterized by rapid growth, early metastatic spread, and initial responsiveness to therapy. Although the incidence of SCLC is declining, it remains one of the common causes of cancer-related mortality. Initial evaluation of patients with SCLC should focus on determining the extent of disease and the ability of the patient to tolerate specific therapy. Positron emission tomography (PET) can improve the accuracy of staging and treatment planning in many patients...
October 2016: Seminars in Respiratory and Critical Care Medicine
Jianlin Xu, Haitang Yang, Xiaolong Fu, Bo Jin, Yuqing Lou, Yanwei Zhang, Xueyan Zhang, Hua Zhong, Huimin Wang, Dan Wu, Baohui Han
INTRODUCTION: Data on prophylactic cranial irradiation (PCI) after complete resection of SCLC are limited. The purpose of this study was to investigate the impact of PCI in this population. METHODS: We retrospectively identified completely resected SCLC at the Shanghai Chest Hospital between January 2006 and January 2014. RESULTS: A total of 349 patients (115 patients who received PCI [the PCI-treated cohort] and 234 patients who did not [the non-PCI-treated cohort]) were included in the study...
October 7, 2016: Journal of Thoracic Oncology
Margot Lehman, Peter Gorayski, Susanne Watson, Desiree Edeling, James Jackson, Jennifer Whitty
INTRODUCTION: In patients with non-small cell lung cancer (NSCLC) treated with chemoradiotherapy (CRT), prophylactic cranial irradiation (PCI) is not standard practice. This study determined patient preferences for PCI with respect to survival benefit, reduction in brain metastases (BM) and acceptable toxicity. METHODS: A Discrete Choice Experiment was completed pre- and post-treatment. Patients made 15 hypothetical choices between two alternative PCI treatments described by four attributes: amount of life gained, chance of BM, ability to care for oneself, and loss of memory...
October 4, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Xin-Ru Chen, Jian-Zhong Liang, Shu-Xiang Ma, Wen-Feng Fang, Ning-Ning Zhou, Hai Liao, De-Lan Li, Li-Kun Chen
BACKGROUND: Concurrent chemoradiotherapy (CCRT) is the standard treatment for limited-stage small-cell lung cancer (LD-SCLC). However, the efficacy of consolidation chemotherapy (CCT) in LD-SCLC remains controversial despite several studies that were performed in the early years of CCT use. The aim of this study was to reevaluate the effectiveness and toxicities associated with CCT. METHODS: This retrospective analysis evaluated 177 patients with stage IIIA and IIIB small-cell lung cancer (SCLC) who underwent CCRT from January 2001 to December 2013 at Sun Yat-Sen University Cancer Center (SYSUCC)...
2016: OncoTargets and Therapy
K J Redmond, R K Hales, X C Zhou, M Kummerlowe, H Sair, M Duhon, L R Kleinberg, G Rosner, T Vannorsdall
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
A Jain, J Luo, Y Chen, M A Henderson, C R Thomas, T Mitin
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Xiaoyan Ma, Hui Zhu, Hongbo Guo, Anqin Han, Haiyong Wang, Wang Jing, Yan Zhang, Li Kong, Jinming Yu
Controversial value of prophylactic cranial irradiation (PCI) in NSCLC in terms of survival benefit prompted us to explore the possible risk factors for brain metastasis (BM) during the course of EGFR-TKIs therapy from EGFR-mutated advanced lung adenocarcinoma and identify the potential population most likely to benefit from PCI, because BM remains a therapeutically challenging issue. We retrospectively reviewed the records of 134 patients with EGFR-mutated advanced lung adenocarcinoma between 2008 and 2012...
September 8, 2016: Oncotarget
N Pourel
Radiotherapy for small cell lung carcinoma has known significant improvements over the past 10 years especially through routine use of PET-CT in the initial work-up and contouring before treatment. Prophylactic cranial irradiation remains a standard of care for locally advanced disease and is a subject of controversy for metastatic disease. A new indication for thoracic radiotherapy may soon arise for metastatic disease, still confirmation studies are ongoing.
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Yi Chen, Jinyu Li, Yi Hu, Yibao Zhang, Zhi Lin, Zhifei Zhao, Shunchang Jiao
OBJECTIVE: To evaluate the effect of prophylactic cranial irradiation (PCI) on overall survival (OS) in patients with extensive small cell lung cancer (ESCLC). METHODS: Between April 2005 and May 2014, 204 patients with ESCLC who had any response (according to RECIST 1.1) to initial chemotherapy were reviewed. All patients had undergone appropriate imaging tests to exclude brain metastases before initial chemotherapy. PCI was performed on 45 patients (22.1 %) and the remaining patients (77...
September 7, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Katalin Fábián, Márton Gyulai, József Furák, Péter Várallyay, Márta Jäckel, Krisztina Bogos, Balázs Döme, Judit Pápay, József Tímár, Zoltán Szállási, Judit Moldvay
BACKGROUND: Brain metastasis of lung cancer adversely affects overall survival (OS) and quality of life, while peritumoral brain edema is responsible for life-threatening complications. METHODS: We retrospectively analyzed the clinicopathological and cerebral radiological data of 575 consecutive lung cancer patients with brain metastases. RESULTS: In adenocarcinoma and squamous cell carcinoma, peritumoral brain edema was more pronounced than in small-cell lung cancer (p < 0...
August 26, 2016: Oncology
Tarje Onsøien Halvorsen, Stein Sundstrøm, Øystein Fløtten, Odd T Brustugun, Paal Brunsvig, Ulf Aasebø, Roy M Bremnes, Stein Kaasa, Bjørn H Grønberg
BACKGROUND: Many patients with limited disease small cell lung cancer (LD SCLC) suffer from comorbidity. Not all patients with comorbidity are offered standard treatment, though there is little evidence for such a policy. The aim of this study was to investigate whether patients with comorbidity had inferior outcomes in a LD SCLC cohort. MATERIAL AND METHODS: We analyzed patients from a randomized study comparing two three-week schedules of thoracic radiotherapy (TRT) plus standard chemotherapy in LD SCLC...
November 2016: Acta Oncologica
Erica B Bernhardt, Shadia I Jalal
Small cell lung cancer (SCLC) is an aggressive cancer of neuroendocrine origin, which is strongly associated with cigarette smoking. Patients typically present with a short duration of symptoms and frequently (60-65 %) with metastatic disease. SCLC is a heterogeneous disease including extremely chemosensitive and chemoresistant clones. For this reason, a high percentage of patients respond to first-line chemotherapy but rapidly succumb to the disease. SCLC is generally divided into two stages, limited and extensive...
2016: Cancer Treatment and Research
D K Woolf, B J Slotman, C Faivre-Finn
Radiotherapy has been shown to play a key role in the management of small cell lung cancer. There are well-established data in the literature for the use of concurrent chemoradiotherapy for stage I-III disease, although key questions remain over the timing of radiation, the optimal dose/fractionation and particularly once versus twice daily treatment, the use of elective nodal irradiation and drug combinations. Data for the use of thoracic radiation in stage IV disease, after chemotherapy, have recently become available and are leading to a change in practice...
November 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Daniel L Smith, Bisrat G Debeb, Howard D Thames, Wendy A Woodward
PURPOSE: Prophylactic cranial irradiation (PCI) involves giving radiation to the entire brain with the goals of reducing the incidence of brain metastasis and improving overall survival. Experimentally, we have demonstrated that PCI prevents brain metastases in a breast cancer mouse model. We developed a computational model to expand on and aid in the interpretation of our experimental results. METHODS AND MATERIALS: MATLAB was used to develop a computational model of brain metastasis and PCI in mice...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
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