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Prophylactic Cranial Irradiation

Yi Chen, Jinyu Li, Yibao Zhang, Yi Hu, Guoqing Zhang, Xiang Yan, Zhi Lin, Zhifei Zhao, Shunchang Jiao
OBJECTIVE: Previous studies demonstrated that prophylactic cranial irradiation (PCI) significantly reduced the incidence of brain metastases in patients with extensive disease small cell lung cancer (ED-SCLC). However, the appropriate timing for PCI in treating ED-SCLC is still unclear. This study aimed to compare the effect and safety of early versus late PCI. METHODS: Between November 2011 and July 2016, 103 patients with ED-SCLC were reviewed, receiving appropriate imaging tests to exclude brain metastases prior to cranial irradiation...
May 17, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Ryoko Suzuki, Ritsuko Komaki
Prophylactic cranial irradiation (PCI) has been considered standard of care for patients with limited-stage small-cell lung cancer who achieve complete response to definitive treatment after a meta-analysis revealed its favorable effects on survival. In a European trial, PCI was also shown to confer a survival advantage for patients with extensive-stage (ES) SCLC who experienced any positive response after initial chemotherapy, leading to PCI also being considered a standard treatment for these patients as well...
May 7, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Kaname Nosaki, Takashi Seto, Mototsugu Shimokawa, Toshiaki Takahashi, Nobuyuki Yamamoto
Throughout the entire world, prophylactic cranial irradiation (PCI) is the standard care for patients with small cell lung cancer (SCLC) in whom a favorable therapeutic effect is achieved after front-line treatment, regardless of whether the disease is in the limited stage or extensive stage. In the EORTC study, PCI was shown to confer a survival benefit for patients with extensive-stage small cell lung cancer (ES-SCLC) who experienced any positive response after initial chemotherapy. However, the Japan study failed to confirm a survival benefit...
May 7, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Karine A Al Feghali, Rami A Ballout, Assem M Khamis, Elie A Akl, Fady B Geara
Background: We systematically reviewed the literature for trials addressing the efficacy of prophylactic cranial irradiation (PCI) in patients with non-small-cell lung cancer (NSCLC) treated with a curative intent. Methods: Randomized controlled trials (RCT) comparing PCI to no PCI in patients with NSCLC treated with a curative intent were eligible for inclusion. We searched EMBASE, MEDLINE, PubMed, and CENTRAL between 1946 and July 2016. We also received continual search alerts from PubMed through September 2017...
2018: Frontiers in Oncology
Nobuaki Mamesaya, Kazushige Wakuda, Katsuhiro Omae, Eriko Miyawaki, Mie Kotake, Takumi Fujiwara, Takahisa Kawamura, Haruki Kobayashi, Kazuhisa Nakashima, Shota Omori, Akira Ono, Hirotsugu Kenmotsu, Tateaki Naito, Haruyasu Murakami, Keita Mori, Hideyuki Harada, Masahiro Endo, Takashi Nakajima, Toshiaki Takahashi
Background: Prophylactic cranial irradiation (PCI) is recommended for patients with limited-disease small-cell lung cancer (LD-SCLC) who achieved good response to definitive chemoradiotherapy. However, most clinical studies lacked brain imaging scans before PCI. Our study aimed to investigate whether PCI has a survival benefit in patients who have no brain metastases (BM) confirmed via magnetic resonance imaging (MRI) before PCI. Results: Eighty patients were included in this study...
April 3, 2018: Oncotarget
Terence T Sio, Anussara Prayongrat, Yun Zhang, Qin Lin, Ting Xu, Zhongxing Liao, Jinbo Yue
New randomized data from Japan have raised questions regarding the use of prophylactic cranial irradiation for patients with extensive-stage small-cell lung cancer but without detectable brain metastases on magnetic resonance imaging. In the present focused review, we examine the general role of prophylactic cranial irradiation in the management of small-cell lung cancer and present relevant controversies from both sides of the discussion. Future directions for clinical investigation and research are also highlighted...
March 16, 2018: Clinical Lung Cancer
E Fernström, K Minta, U Andreasson, Å Sandelius, P Wasling, A Brinkmalm, K Höglund, K Blennow, J Nyman, H Zetterberg, M Kalm
BACKGROUND: Advances in the treatment of brain tumors have increased the number of long-term survivors, but at the cost of side effects following cranial radiotherapy ranging from neurocognitive deficits to outright tissue necrosis. At present, there are no tools reflecting the molecular mechanisms underlying such side effects, and thus no means to evaluate interventional effects after cranial radiotherapy. Therefore, fluid biomarkers is of great clinical interest. OBJECTIVE: Cerebrospinal fluid (CSF) levels of proteins involved in inflammatory signaling, synaptic plasticity and extracellular matrix (ECM) integrity were investigated following radiotherapy to the brain...
April 17, 2018: Journal of Internal Medicine
S Deprez, Michiel B de Ruiter, S Bogaert, R Peeters, J Belderbos, D De Ruysscher, S Schagen, S Sunaert, P Pullens, E Achten
PURPOSE: The aim of this study is to assess multi-center reproducibility and longitudinal consistency of MRI imaging measurements, as part of a phase III longitudinal multi-center study comparing the neurotoxic effect following prophylactic cranial irradiation with hippocampal avoidance (HA-PCI), in comparison with conventional PCI in patients with small-cell lung cancer. METHODS: Harmonized MRI acquisition protocols from six participating sites and two different vendors were compared using both physical and human phantoms...
April 14, 2018: Neuroradiology
Matthew J Farrell, Jehan B Yahya, Catherine Degnin, Yiyi Chen, John M Holland, Mark A Henderson, Jerry J Jaboin, Matthew M Harkenrider, Charles R Thomas, Timur Mitin
PURPOSE: Prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer (LS-SCLC) is considered the standard of care. Meta-analysis of 7 clinical trials indicates a survival benefit to PCI, but all of these trials were conducted in the pre-magnetic resonance imaging (MRI) era. Therefore, routine brain imaging with MRI before PCI-as recommended by National Comprehensive Cancer Network guidelines-is not directly supported by the evidence. Current US practice patterns for patients with LS-SCLC are unknown...
February 23, 2018: Clinical Lung Cancer
Tyler P Robin, Timothy S Sannes, Feng-Ming Spring Kong, Francoise Mornex, Fred R Hirsch, Chad G Rusthoven, Laurie E Gaspar
INTRODUCTION: Guidelines have recommended prophylactic cranial irradiation (PCI) for patients with limited-stage small-cell lung cancer with at least a partial response after thoracic chemoradiation. However, the survival advantage has been small and was observed in an era before magnetic resonance imaging and surveillance. Neurotoxicity also remains a concern, especially in older adults. Thus, patients have a complex value-laden decision to make. We sought to better understand the role physicians play in patient decision making and introduce a patient decision aid (PDA) to potentially facilitate these discussions...
February 17, 2018: Clinical Lung Cancer
Patrizia Ciammella, Giorgia Timon, Alessio Bruni, Davide Franceschini, Paolo Borghetti, Nicolò Giaj-Levra, Carlo Greco, Vieri Scotti, Marco Trovo
INTRODUCTION: Radiation therapy plays an important role in the management of SCLC both in curative and palliative setting, however, conflicting data from clinical trials incite debate over the appropriate use of radiation therapy regarding prophylactic cranial irradiation (PCI) and/or thoracic consolidative in extensive-stage SCLC (ES-SCLC). This survey is conducted to evaluate the current pattern of care among Italian radiation oncologists. METHODS: In June 2016, all Italian radiation oncologists were invited to a web-based survey...
March 13, 2018: La Radiologia Medica
Macy Liu
No abstract text is available yet for this article.
February 2018: Translational Lung Cancer Research
Chi Hoon Maeng, Jae-Uk Song, Sung Ryul Shim, Jonghoo Lee
INTRODUCTION: The role of prophylactic cranial irradiation (PCI) is controversial in patients with extensive stage small cell lung cancer. The aim of this study was to determine the impact of PCI in these patients. METHODS: We performed a systematic review and meta-analysis in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A systematic literature search was conducted in MEDLINE, EMBASE, and the Cochrane Central Register...
March 8, 2018: Journal of Thoracic Oncology
(no author information available yet)
BACKGROUND: Prophylactic cranial irradiation halves the rate of brain metastases in patients with small cell lung cancer. Individual randomized trials conducted on patients in complete remission were unable to clarify whether this treatment improves survival. OBJECTIVES: This study aims to test whether prophylactic cranial irradiation prolongs survival of patients with small cell lung cancer in complete remission. SEARCH METHODS: Published and unpublished trials were eligible...
February 6, 2018: Cochrane Database of Systematic Reviews
Ryoko Suzuki, Steven H Lin, Xiong Wei, Pamela K Allen, James W Welsh, Lauren A Byers, Ritsuko Komaki
BACKGROUND: We evaluated pretreatment total lymphocyte count (TLC, marker of immunosuppression), neutrophil-to-lymphocyte ratio (NLR, marker of inflammation), and overall survival (OS) in patients with extensive-stage small-cell lung cancer (ES-SCLC). METHODS: Pretreatment blood characteristics, age, sex, performance status, race, stage (M1a vs. M1b), number and location of metastases, weight loss, smoking status, chemotherapy cycles (<4 vs. ≥4), thoracic radiotherapy dose (<45 vs...
March 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Sonam Sharma, Matthew T McMillan, Abigail Doucette, Roger B Cohen, Abigail Berman, William Levin, Charles B Simone, Jacob Shabason
INTRODUCTION: Patients with small-cell lung cancer (SCLC) have a high incidence of occult brain metastases and are often treated with prophylactic cranial irradiation (PCI). Despite a small survival advantage in some studies, the role of PCI in extensive stage SCLC remains controversial. We used the National Cancer Database to assess survival of patients with metastatic SCLC treated with PCI. PATIENTS AND METHODS: Metastatic SCLC patients without brain metastases were identified...
December 14, 2017: Clinical Lung Cancer
(no author information available yet)
Since the beginning of 2017, Chinese Journal of Cancer has published a series of important questions in cancer research and clinical oncology, which spark diverse thoughts, interesting communications, and potential collaborations among researchers all over the world. In this article, 8 more questions are presented as follows. Question 86. In which circumstances is good supportive care associated with a survival advantage in patients with cancer? Question 87. Can we develop animal models to mimic immunotherapy response of cancer patients? Question 88...
January 22, 2018: Chinese Journal of Cancer
Yang Yang, Danhong Zhang, Xia Zhou, Wuan Bao, Yonglin Ji, Liming Sheng, Lei Cheng, Ying Chen, Xianghui Du, Guoqin Qiu
Background: The use of PCI in early operable patients with small cell lung cancer (SCLC) is still controversial. Therefore, we conducted a systematic review with meta-analysis to investigate the effects of PCI in resected SCLC patients. Methods: Relevant studies were identified from PubMed and EMBASE databases, the pooled hazard risks were obtained by the random-effects model. We also analyzed the brain metastasis (BM) risk in p-stage I patients without PCI. Results: Five retrospective studies were identified and a total of 1691 patients were included in our analysis, 315 of them received PCI...
2018: Journal of Cancer
Xiaozhen Liu, Tao Jiang, Wei Li, Xuefei Li, Chao Zhao, Jinpeng Shi, Sha Zhao, Yijun Jia, Meng Qiao, Limin Zhang, Jiawei Luo, Guanghui Gao, Fei Zhou, Fengying Wu, Xiaoxia Chen, Yayi He, Shengxiang Ren, Chunxia Su, Caicun Zhou
OBJECTIVES: Small-cell lung cancer (SCLC) has been viewed as a smoking-related disease, with only 2% to 5% patients being never-smokers. This study aimed to investigate the clinical characteristics of never-smoking and its association with treatment outcomes in Chinese SCLC patients in real world. METHODS: We performed a retrospective study of 303 patients with SCLC and grouped into smokers and never-smokers. The clinical characteristics and treatment outcomes of two groups were collected and compared...
January 2018: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Crystalrose Precival, Mickayla Landy, Claire Poole, Laura Mullaney
BACKGROUND: The use of prophylactic cranial irradiation (PCI) to treat brain metastases (BM) in non-small cell lung cancer (NSCLC) is restricted due to the potential associated toxicity and lack of survival benefit. BM can have a negative impact on neurocognitive function (NF) and quality of life (QOL). The aim of this review was to assess the impact of PCI on disease-specific and NF and QOL outcomes. MATERIALS AND METHODS: An electronic database literature search was completed to identify relevant studies...
January 2018: Anticancer Research
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