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Prophylactic Cranial Irradiation

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https://www.readbyqxmd.com/read/29344290/prophylactic-cranial-irradiation-in-resected-small-cell-lung-cancer-a-systematic-review-with-meta-analysis
#1
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
https://www.readbyqxmd.com/read/29290250/characterization-of-never-smoking-and-its-association-with-clinical-outcomes-in-chinese-patients-with-small-cell-lung-cancer
#2
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
https://www.readbyqxmd.com/read/29277750/the-role-of-prophylactic-cranial-irradiation-for-non-small-cell-lung-cancer
#3
REVIEW
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
https://www.readbyqxmd.com/read/29208355/usage-of-prophylactic-cranial-irradiation-in-elderly-patients-with-small-cell-lung-cancer
#4
Ronald A M Damhuis, Suresh Senan, Jose S Belderbos
BACKGROUND: Prophylactic cranial irradiation (PCI) reduces the risk of overt brain metastases in patients with small-cell lung cancer (SCLC) and is currently recommended in guidelines for both limited and extensive disease. Given the concerns about the greater frequency of neurologic side effects in elderly patients, we studied the association among age, PCI usage, and survival for SCLC patients in the Netherlands. PATIENTS AND METHODS: Data from the Netherlands Cancer Registry for patients diagnosed with SCLC from 2009 to 2013 were queried...
November 21, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29204521/factors-influencing-the-utilization-of-prophylactic-cranial-irradiation-in-patients-with-limited-stage-small-cell-lung-cancer
#5
Benjamin H Lok, Jennifer Ma, Amanda Foster, Carmen A Perez, Weiji Shi, Zhigang Zhang, Bob T Li, Charles M Rudin, Andreas Rimner, Abraham J Wu
Purpose: Brain metastases are common in patients with limited-stage small cell lung cancer (LS-SCLC) due to the inability of most chemotherapeutics to penetrate the blood-brain barrier. Prophylactic cranial irradiation (PCI) is therefore recommended for use in patients with a good response to concurrent chemoradiotherapy. However, PCI is not always delivered; therefore, we investigated the reasons for PCI omission in patients who underwent therapy with curative intent. Methods and materials: We retrospectively reviewed all patients with LS-SCLC who were treated with curative intent at our institution...
October 2017: Advances in Radiation Oncology
https://www.readbyqxmd.com/read/29153967/the-role-of-advanced-imaging-in-assessing-response-to-definitive-chemoradiation-before-prophylactic-cranial-irradiation-in-limited-stage-small-cell-lung-cancer
#6
Aparna H Kesarwala, Diana J Lu, Eric Xanthopoulos, Smith Apisarnthanarax, Keith A Cengel, Tracey L Evans, Charu Aggarwal, Roger B Cohen, Corey J Langer, Ramesh Rengan, Charles B Simone
INTRODUCTION: Prophylactic cranial irradiation (PCI) improves survival for small-cell lung cancer (SCLC). Evidence for PCI in limited-stage SCLC largely derives from studies requiring only chest x-ray (CXR) to determine remission status. We analyzed thoracic chemoradiation therapy (TCRT) outcomes according to imaging modality to determine which patients benefitted most from PCI. PATIENTS AND METHODS: All limited-stage SCLC patients who received TCRT as well as PCI at our institution were reviewed...
October 12, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/29147667/metastasectomy-of-solitary-adrenal-metastasis-from-small-cell-lung-cancer
#7
Dat Cao Pham, Ziad Awad, Bradford S Hoppe, Jason Hew, Ke Ning
Most extensive-stage small cell lung cancers have disseminated disease at diagnosis, and solitary adrenal metastasis from small cell lung cancer is rare. We report the case of a 51-year-old man with extensive-stage small cell lung cancer with solitary right adrenal metastasis (T2N0M1), who was cured with resection of primary tumor, chemotherapy (cisplatin, etoposide), adrenalectomy, consolidative thoracic radiotherapy, and prophylactic cranial irradiation. He remained cancer free, 7.5 years since diagnosis...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29128167/a-prospective-evaluation-of-hippocampal-radiation-dose-volume-effects-and-memory-deficits-following-cranial-irradiation
#8
Ting Martin Ma, Jimm Grimm, Riley McIntyre, Heather Anderson-Keightly, Lawrence R Kleinberg, Russell K Hales, Joseph Moore, Tracy Vannorsdall, Kristin J Redmond
BACKGROUND AND PURPOSE: To prospectively evaluate hippocampal radiation dose volume effects and memory decline following cranial irradiation. MATERIAL AND METHODS: Effects of hippocampal radiation over a wide range of doses were investigated by combining data from three prospective studies. In one, adults with small cell lung cancer received hippocampal-avoidance prophylactic cranial irradiation. In the other two, adults with glioblastoma multiforme received neural progenitor cell sparing radiation or no sparing with extra dose delivered to subventricular zone...
November 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29125928/the-tippy-barstool-of-prophylactic-cranial-irradiation
#9
James J Urbanic
No abstract text is available yet for this article.
November 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29125923/prophylactic-cranial-irradiation-for-extensive-small-cell-lung-cancer
#10
Steven E Schild, Terence T Sio, Thomas B Daniels, Stephen G Chun, Dirk Rades
Small-cell lung cancer (SCLC) has a high predilection for metastasizing to the brain after chemotherapy. This has been blamed on the blood-brain barrier, which prevents chemotherapy from penetrating into the brain, thus creating a sanctuary site. It has been estimated that up to three quarters of patients with SCLC will eventually develop brain metastases. This led investigators to administer prophylactic cranial irradiation (PCI) to decrease this risk. Several trials were performed in patients with SCLC after initial therapy (chemotherapy with or without thoracic radiotherapy) that compared the outcomes of PCI versus no PCI...
November 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29125922/is-prophylactic-cranial-irradiation-the-standard-of-care-for-extensive-stage-small-cell-lung-cancer
#11
Angel Qin, Gregory P Kalemkerian
No abstract text is available yet for this article.
November 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29077861/the-role-of-prophylactic-cranial-irradiation-for-patients-with-small-cell-lung-cancer
#12
Yoshiro Nakahara, Jiichiro Sasaki, Tomoya Fukui, Sakiko Otani, Satoshi Igawa, Kazushige Hayakawa, Noriyuki Masuda
Small-cell lung cancer (SCLC) has a particular propensity to metastasize to the brain, affecting ~10% of SCLC patients at diagnosis, but may occur in more than 50% of 2-year survivors. Most cytotoxic drugs have limited ability to cross the blood-brain barrier, and the effectiveness of chemotherapy for brain metastasis is limited. Therefore, prophylactic cranial irradiation (PCI) has been proposed to treat SCLC. A meta-analysis revealed that PCI significantly decreased the risk of brain metastasis and increased the 3-year survival rate; it has been established as a standard therapy for limited-disease SCLC...
October 25, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29034208/prophylactic-cranial-irradiation-following-surgical-resection-of-early-stage-small-cell-lung-cancer-a-review-of-the-literature
#13
REVIEW
Brooke C Bloom, Alexander Augustyn, Boris Sepesi, Sunil Patel, Shalin J Shah, Ritsuko U Komaki, Steven E Schild, Stephen G Chun
With increasing use of low-dose screening CT scans, the diagnosis of early-stage small-cell lung cancer (SCLC) without evidence of mediastinal nodal or distant metastasis is likely to become more common, but the role of adjuvant therapies such as prophylactic cranial irradiation (PCI) are not well understood in this population. We performed a review of the literature pertaining to the impact of PCI in patients who underwent surgical resection of early-stage SCLC. Four studies were identified that were pertinent including three single-institution retrospective analyses and a National Cancer Database analysis...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/29029885/cost-effectiveness-of-thoracic-radiation-therapy-for-extensive-stage-small-cell-lung-cancer-using-evidence-from-the-chest-radiotherapy-extensive-stage-small-cell-lung-cancer-trial-crest
#14
Grace I Patrice, Nataniel H Lester-Coll, James B Yu, Jordan Amdahl, Thomas E Delea, Stephen J Patrice
PURPOSE: The Chest Radiotherapy Extensive-Stage Small Cell Lung Cancer Trial (CREST) showed that adding thoracic radiation therapy (TRT) to the standard treatment (ST) paradigm of chemotherapy and prophylactic cranial irradiation improves overall survival and progression-free survival (PFS) in patients with extensive-stage small cell lung cancer (ES-SCLC). We evaluated the cost-effectiveness of adding TRT to ST in ES-SCLC patients. METHODS AND MATERIALS: A cost-utility analysis was performed comparing TRT plus ST versus ST alone...
September 4, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28992110/nfat3-c4-mediated-excitotoxicity-in-hippocampal-apoptosis-during-radiation-induced-brain-injury
#15
Meiling Xu, Qiuhong Fan, Junjun Zhang, Yanfang Chen, Ruizhe Xu, Liesong Chen, Peifeng Zhao, Ye Tian
Whole brain irradiation (WBI) has become an indispensible tool in the treatment of head and neck cancer, and it has greatly improved patient survival rate and total survival time. In addition, prophylactic cranial irradiation (PCI) has dramatically decreased the incidence of brain metastatic carcinoma. However, WBI may induce temporary functional deficits or even progressive, irreversible cognitive dysfunction that compromises the quality of life for survivors. Unfortunately, the exact molecular mechanisms for cognitive damage remain elusive, and no treatment or preventative measures are available for use in the clinic...
August 10, 2017: Journal of Radiation Research
https://www.readbyqxmd.com/read/28958889/prophylactic-cranial-irradiation-for-resectable-small-cell-lung-cancer
#16
REVIEW
Aditya Halthore, Anuj Goenka, Rajiv Sharma, Jonathan P S Knisely
After definitive chemoradiation for small-cell lung cancer (SCLC), prophylactic cranial irradiation (PCI) has been established as standard of care in patients whose tumors respond to treatment. In the modern era, however, a subset of patients might receive upfront resection for SCLC, yet the role of PCI in these patients has not been elucidated. In this review, we examine the literature to better define the role of PCI in this subset of patients. For patients with ≥ T2 disease, incomplete resection, or those not receiving adjuvant chemotherapy, PCI is expected to offer a clinical benefit...
August 26, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28882584/prophylactic-cranial-irradiation-pci-versus-active-mri-surveillance-for-small-cell-lung-cancer-the-case-for-equipoise
#17
REVIEW
Chad G Rusthoven, Brian D Kavanagh
Prophylactic cranial irradiation (PCI) for SCLC offers a consistent reduction in the incidence of brain metastases 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 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 overall survival with PCI omission in the context of modern magnetic resonance imaging (MRI) staging and surveillance...
December 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
#18
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
#19
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
#20
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
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