Non-small cell lung cancer and central nervous system metastases: should we be using prophylactic cranial irradiation? Semin Radiat Oncol 2004 Oct;14(4):292-7
Date
11/24/2004Pubmed ID
15558503DOI
10.1016/j.semradonc.2004.06.001Scopus ID
2-s2.0-8844283481 (requires institutional sign-in at Scopus site) 13 CitationsAbstract
Central nervous system (CNS) failure in patients with locally advanced non-small cell; lung cancer (LA-NSCLC) is a common and debilitating problem. Standard follow-up after local regional therapy does not include routine radiologic evaluation of the brain. Imaging is performed at the onset of symptoms followed by palliative therapy for CNS failure. Some investigators support regular screening with therapy for failures before the onset of symptoms. This alternative may decrease the impact of CNS failures and lengthen survival. Other investigators have shown that prophylactic cranial irradiation (PCI) for LA-NSCLC decreases the incidence of CNS failures. The potential survival, quality of life, and neuropsychological advantage or disadvantage of these two approaches has not been systematically studied. This article will review the problem of CNS failures in patients with LA-NSCLC and the potential risks and benefits of close observation and PCI. The necessity of conducting an ambitious study evaluating the potential survival advantage of PCI will be discussed.
Author List
Gore E, Choy HAuthor
Elizabeth M. Gore MD Professor in the Radiation Oncology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Brain NeoplasmsCarcinoma, Non-Small-Cell Lung
Clinical Trials as Topic
Cognition Disorders
Cranial Irradiation
Humans
Lung Neoplasms
Prognosis
Quality of Life
Survival Analysis