Faculty Collaboration Database

Prophylactic cranial irradiation for patients with lung cancer. Lancet Oncol 2016 Jul;17(7):e277-e293

Date

07/12/2016

Pubmed ID

27396646

DOI

10.1016/S1470-2045(16)30065-1

Scopus ID

2-s2.0-84991086097 (requires institutional sign-in at Scopus site)   92 Citations

Abstract

The incidence of brain metastases in patients with lung cancer has increased as a result of improved local and systemic control and better diagnosis from advances in brain imaging. Because brain metastases are responsible for life-threatening symptoms and serious impairment of quality of life, resulting in shortened survival, prophylactic cranial irradiation has been proposed in both small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) to try to improve incidence of brain metastasis, survival, and eventually quality of life. Findings from randomised controlled trials and a meta-analysis have shown that prophylactic cranial irradiation not only reduces the incidence of brain metastases in patients with SCLC and with non-metastatic NSCLC, but also improves overall survival in patients with SCLC who respond to first-line treatment. Although prophylactic cranial irradiation is potentially associated with neurocognitive decline, this risk needs to be balanced against the potential benefit in terms of brain metastases incidence and survival. Several strategies to reduce neurotoxicity are being investigated.

Author List

Péchoux CL, Sun A, Slotman BJ, De Ruysscher D, Belderbos J, Gore EM

Author

Elizabeth M. Gore MD Professor in the Radiation Oncology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Brain Neoplasms
Cranial Irradiation
Humans
Lung Neoplasms
Quality of Life