Prophylactic Cranial Irradiation in Extensive Small-Cell Lung Cancer

Symptomatic brain metastases are a major clinical problem in small-cell lung cancer. This trial compared prophylactic cranial irradiation with observation in patients with small-cell lung cancer who had had any response to chemotherapy. Prophylactic irradiation reduced the risk of symptomatic brain...

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Bibliographic Details
Published in:The New England journal of medicine Vol. 357; no. 7; pp. 664 - 672
Main Authors: Slotman, Ben, Faivre-Finn, Corinne, Kramer, Gijs, Rankin, Elaine, Snee, Michael, Hatton, Matthew, Postmus, Pieter, Collette, Laurence, Musat, Elena, Senan, Suresh
Format: Journal Article
Language:English
Published: Boston, MA Massachusetts Medical Society 16.08.2007
Subjects:
Adult
Aged
Biological and medical sciences
Brain
Brain Neoplasms - epidemiology
Brain Neoplasms - prevention & control
Brain Neoplasms - secondary
Carcinoma, Small Cell - drug therapy
Carcinoma, Small Cell - mortality
Carcinoma, Small Cell - radiotherapy
Carcinoma, Small Cell - secondary
Clinical trials
Combined Modality Therapy
Cranial Irradiation
Disease-Free Survival
Female
General aspects
Humans
Lung cancer
Lung Neoplasms - drug therapy
Lung Neoplasms - mortality
Lung Neoplasms - pathology
Lung Neoplasms - radiotherapy
Male
Medical imaging
Medical sciences
Middle Aged
Prevention and actions
Preventive medicine
Public health. Hygiene
Public health. Hygiene-occupational medicine
Quality of Life
Radiation therapy
Risk
Risk factors
Survival Analysis
Medicine
Prevention
Lung disease
Treatment
Respiratory disease
Lung cancer
Bonchopulmonary small cell carcinoma
Irradiation
Bronchus disease
Skull
Malignant tumor
Radiotherapy
ISSN:0028-4793, 1533-4406, 1533-4406
Online Access:Get full text
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Description
Summary:Symptomatic brain metastases are a major clinical problem in small-cell lung cancer. This trial compared prophylactic cranial irradiation with observation in patients with small-cell lung cancer who had had any response to chemotherapy. Prophylactic irradiation reduced the risk of symptomatic brain metastases and was associated with longer overall survival. Prophylactic cranial irradiation reduced the risk of symptomatic brain metastases and was associated with longer overall survival. Small-cell lung cancer constitutes nearly 13% of all newly diagnosed lung cancers. 1 Most patients present with extensive disease, and without treatment, the median survival is 2 to 4 months. Chemotherapy has improved short-term survival, but long-term survival remains disappointing. The 2-year survival rate among patients with extensive small-cell lung cancer was 1.5% in 1973 and 4.6% in 2000. 1 Brain metastases are common in this disease. At diagnosis, at least 18% of patients have brain metastases, 2 and the incidence of such metastases increases considerably during the course of the disease, approaching 80% at 2 years. 3 The presence of brain metastases is . . .
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ISSN:0028-4793
1533-4406
1533-4406
DOI:10.1056/NEJMoa071780