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Vol.42 No.7 contents | Japanese/English |
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PCI in CR Patients With SCLC
Con: Satoshi Ishikura11Radiation Oncology Division, National Cancer Center Hospital East, Japan.
Patients with limited-disease small cell lung cancer (LD-SCLC) are treated with cisplatin-containing chemotherapy combined with radiotherapy and the 5-year survival is expected to be 20-25%. As the outcome of treatment and local control have been improved, brain metastasis has become a major site of first failure and prophylactic cranial irradiation (PCI) has been investigated to prevent brain metastasis. The conditions for PCI to be clinically useful are that brain metastasis is the only site of recurrence in most patients, that PCI is effective to eradicate microscopic metastasis, that the toxicity of PCI is not severe, and that PCI prolongs the survival. The metaanalysis of PCI trials reported in 1999 concluded that PCI should be considered for patients who obtain complete response (CR) after first-line treatment. However, issues such as the diagnostic modality used in response evaluation, optimal dose and timing, and precise evaluation of late toxicity remain unsolved. Here these issues are reviewed and future directions are indicated.
key words: Small cell lung cancer, Prophylactic cranial irradiation, Complete response
JJLC 42 (7): 812-814, 2002
