Is prophylactic cranial irradiation indicated in small-cell lung cancer?

James F. Fleck, Lawrence Einhorn, Richard C. Lauer, Stephen M. Schultz, Michael E. Miller

Research output: Contribution to journalArticle

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Abstract

Although prophylactic cranial irradiation (PCI) is frequently used in the treatment of patients with limited-extent small-cell lung cancer (SCLC), its role remains controversial. One hundred fourteen SCLC patients with limited disease treated at Indiana University were retrospectively reviewed. Fifty-eight of 114 (51%) patients achieved a complete remission (CR) and were analyzed. Thirty-eight of these 58 CR patients received PCI (+ PCI) and 20 of 58 CR patients did not receive PCI (-PCI). Twenty-six of 38 patients who received PCI subsequently relapsed. No patient initially relapsed in the CNS, although one patient had a brain metastasis following recurrence in the chest. Eleven of 38 patients who were treated with PCI survived for longer than 30 months and were considered long-term survivors. Seven of these 11 patients (63%) developed clinically significant neurological toxicity. Sixteen of 20 patients who did not receive PCI relapsed, but there was only one initial relapse in the CNS. Three additional patients who relapsed in the chest subsequently developed CNS metastasis. All responded to palliative radiation with improvement in their symptoms. The high incidence of CNS toxicity in the long-term survivors and the relatively infrequent incidence of isolated CNS recurrent in patients not subjected to PCI raise serious questions concerning the role, if any, of PCI in limited SCLC.

Original languageEnglish
Pages (from-to)209-214
Number of pages6
JournalJournal of Clinical Oncology
Volume8
Issue number2
StatePublished - 1990

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Cranial Irradiation
Small Cell Lung Carcinoma
Survivors
Thorax
Neoplasm Metastasis
Recurrence
Incidence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Fleck, J. F., Einhorn, L., Lauer, R. C., Schultz, S. M., & Miller, M. E. (1990). Is prophylactic cranial irradiation indicated in small-cell lung cancer? Journal of Clinical Oncology, 8(2), 209-214.

Is prophylactic cranial irradiation indicated in small-cell lung cancer? / Fleck, James F.; Einhorn, Lawrence; Lauer, Richard C.; Schultz, Stephen M.; Miller, Michael E.

In: Journal of Clinical Oncology, Vol. 8, No. 2, 1990, p. 209-214.

Research output: Contribution to journalArticle

Fleck, JF, Einhorn, L, Lauer, RC, Schultz, SM & Miller, ME 1990, 'Is prophylactic cranial irradiation indicated in small-cell lung cancer?', Journal of Clinical Oncology, vol. 8, no. 2, pp. 209-214.
Fleck, James F. ; Einhorn, Lawrence ; Lauer, Richard C. ; Schultz, Stephen M. ; Miller, Michael E. / Is prophylactic cranial irradiation indicated in small-cell lung cancer?. In: Journal of Clinical Oncology. 1990 ; Vol. 8, No. 2. pp. 209-214.
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