 |
Vol.42 No.7 contents | Japanese/English |
 | Full Text of PDF (153K) Article in Japanese |
- -
Prophylactic Cranial Irradiation is a Standard Treatment in Patients With Small-Cell Lung Cancer Achieving Complete Response
Hiroshi Ueoka11Department of Internal Medicine II, Okayama University Medical School, Japan.
Objective and method. A review of the literature was carried out to determine the usefulness of prophylactic cranial irradiation (PCI) in patients with small-cell lung cancer (SCLC). Results. In the many comparative trials performed until the 1980s, PCI was shown to decrease the incidence of brain metastasis, however no reports revealed a survival advantage. Furthermore, since PCI seemed to be associated with a variety of types of neurological impairment, the role of PCI had not been established. Auperin et al then conducted a meta-analysis of seven randomized trials and reported that PCI significantly improved both incidence of brain metastasis and survival (3-year survival rate: 20.7% vs 15.3%, P=0.01) among patients with SCLC in complete remission (CR). According to the two trials conducted by Arriagada et al and Gregor et al, the incidence of neither cognitive function impairment nor brain atrophy on CT scan was increased by PCI. Conclusion. PCI is considered to be a standard treatment in patients with SCLC achieving CR. Further research is needed to define optimal dose, fractionation and timing, and to clarify the possibility of delayed neurological toxicity.
key words: Small-cell lung cancer, PCI, CR
JJLC 42 (7): 805-811, 2002
