Book
Radiation Therapy: Types,Procedures and Outcomes the Role of Prophylactic Cranial Irradiation in Limited Stage Small Cell Lung Cancer.
(2015)
Abstract
Lung cancer is estimated to have an incidence of 24,100 and will cause 20,600 deaths in Canada in 2010 per Canadian Cancer Society Statistics. Small cell lung cancer tends to spread to the brain. Brain metastases adversely affect the patient’s quality of life. To eradicate microscopic disease in the brain, radiation treatment is given prior to any evidence of cancer spreading to the brain. The optimal dose and timing of prophylactic cranial irradiation (PCI) are controversial. By the time chemotherapy and chest radiation are completed, some patients have already developed brain metastases. This literature review of PCI will address the contemporary PCI issues, i.e. optimal dose, timing and selection criteria of patients for PCI. Early PCI has the theoretical advantage to eradicate micrometastases first. However delaying PCI until the completion of chemotherapy allows adequate chemotherapy as reduced chemotherapy dose intensity had been shown to be detrimental to survival outcome. In addition, increased toxicity of early PCI when given concurrently with chemotherapy is another concern. Currently, the standard of care is to give PCI soon after completion of chemotherapy. In the past most randomized studies were on complete responders after chemo-radiation. Some studies did not give PCI to partial responders, while others did. Partial responders represent a heterogeneous group of patients with responses ranging from minimal to almost complete response. Partial responders do benefit from PCI at least in longer progression-free intervals and decreased rates of brain metastases.
Disciplines
Publication Date
Fall December, 2015
Editor
Andrea Hawkins
Publisher
Nova Science Publishers
Series
Encyclopedia of Lung Cancer, chapter 4
Citation Information
Patricia Tai and Edward Yu. Radiation Therapy: Types,Procedures and Outcomes the Role of Prophylactic Cranial Irradiation in Limited Stage Small Cell Lung Cancer.. New York, USA.(2015) p. 125 - 136 Available at: http://works.bepress.com/edward_yu/151/