Unexpected dementia following prophylactic cranial irradiation for small cell lung cancer: case report
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Prophylactic cranial irradiation (PCI) is commonly offered to patients with limited stage primary small cell lung cancer following a complete response.
We present the unique case of a 76-year-old woman treated with PCI with a dose of 30 Gy in 15 fractions, at 200 cGy per fraction who developed progressive dementia.
This is the first reported case of dementia from PCI at this low dose per fraction. Patients need to be counseled regarding the risks and benefits of treatment, including dementia with treatment and risk of sequelae from CNS metastasis without treatment. The authors review the data supporting PCI and the incidence of radiation associated dementia.
KeywordsBrain Dementia Prophylactic Cranial Irradiation PCI Radiation Small cell lung cancer
- 1.Auperin A, Arriagada R, Pignon JP, Le Pechoux C, Gregor A, Stephens RJ, Kristjansen PE, Johnson BE, Ueoka H, Wagner H, Aisner J (1999) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med 341:476–484PubMedCrossRefGoogle Scholar
- 2.Catane R, Schwade JG, Yarr I, Lichter AS, Tepper JE, Dunnick NR, Brody L, Brereton HD, Cohen M, Glatstein E (1981) Follow-up neurological evaluation in patients with small cell lung carcinoma treated with prophylactic cranial irradiation and chemotherapy. Int J Radiat Oncol Biol Phys 7:105–109PubMedGoogle Scholar
- 5.Gregor A, Cull A, Stephens RJ, Kirkpatrick JA, Yarnold JR, Girling DJ, Macbeth FR, Stout R, Machin D (1997) Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: results of a multicentre randomised trial. United Kingdom Coordinating Committee for Cancer Research (UKCCCR) and the European Organization for Research and Treatment of Cancer (EORTC). Eur J Cancer 33:1752–1758PubMedCrossRefGoogle Scholar
- 8.Kalemkerian GP (2007) NCCN Practice Guidelines Small Cell Lung Cancer v.1Google Scholar
- 9.Turrisi AT, 3rd Kim K, Blum R, Sause WT, Livingston RB, Komaki R, Wagner H, Aisner S, Johnson DH (1999) Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide. N Engl J Med 340:265–271PubMedCrossRefGoogle Scholar