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Vol.37 No.6 contents | Japanese/English |
- Original Article -
Prophylactic Cranial Irradiation for Patients with Limited Disease Small Cell Lung Cancer in Complete Remission
Takuhito Tada1, Kazuo Minakuchi1, Mayuko Koda1, Noriyuki Masuda2, Kaoru Matsui2, Ichiro Kawase2, Toshifumi Nakajima3, Masahiro Fukuoka4 and Takahiro Kozuka11Department of Radiology, Osaka Prefectural Habikino Hospital, 2Second Department of Internal Medicine, Osaka Prefectural Habikino Hospital, 3Department of Radiology, Tenri Hospital, 4Fourth Department of Internal Medicine, Kinki University
Prophylactic cranial irradiation (PCI) in patients with small cell lung cancer has been performed in many countries. While a consensus that PCI decreased the rate of tumor recurrence in the brain has been obtained, the survival advantage of PCI remains controversial. To improve results of PCI, a retrospective study was carried out. Twenty-five patients and 16 patients underwent PCI with doses of 24 Gy (accelerated hyperfractionation) and 30 Gy. Overall survival at 2 and 5 years was 60% and 26% for the patients with a dose of 24 Gy, and 33% and 20% for those with a dose of 30 Gy, respectively. Brain metastasis as the first relapse site was 16% and 13% for the patients with doses of 24 Gy and 30 Gy, and brain metastasis as the only relapse site was 12% and 6%, respectively. As prognostic factors, there were significant differences between patients with less than 65 years of age and 65 or more, and between patients with stage IIIA and stage IIIB. A prospective randomized study with more strict patient selection (stage IIIA disease) and appropriate dose (27-30 Gy) for PCI may prove that PCI provides significant survival benefit.
key words: Prophylactic cranial irradiation, Small cell lung cancer, Complete remission
Received: May 26, 1997
Accepted: July 8, 1997
JJLC 37 (6): 849-854, 1997
