Prophylactic Cranial Irradiation
The incidence of brain metastases following locoregional treatment for locally advanced non-small cell lung cancer (LA-NSCLC) is high. Brain metastases impair quality of life and are associated with a poor prognosis. The rationale behind prophylactic cranial irradiation (PCI) is to control or eradicate undetectable micrometastases before they become clinically significant without inducing severe adverse effects. Given the profound detrimental effect on survival, treatment that reduces the incidence of brain metastases in patients with LA-NSCLC might reasonably be expected to prolong life and improve quality of life. This chapter reviews the role of PCI in LA-NSCLC with specific reference to the five randomized controlled trials carried out in this field.
KeywordsBrain Metastasis Small Cell Lung Cancer Large Cell Carcinoma Prophylactic Cranial Irradiation Locoregional Treatment
- Miller TP, Crowley JJ, Mira J et al (1998) A randomized trial of chemotherapy and radiotherapy for stage III non-small cell lung cancer. Canc Ther 4:229–236Google Scholar
- PCIOCG (The Prophylactic Cranial Irradiation Overview Collaborative Group). Cranial irradiation for preventing brain metastases of small cell lung cancer in patients in complete remission. Cochrane database of systematic reviews (2002), Issue 4. doi: 10.1002/14651858.CD002805
- Russell AH, Pajak TE, Selim HM et al (1991) Prophylactic cranial irradiation for lung cancer patients at high risk for development of cerebral metastasis: results of a prospective randomised trial conduced by the radiation therapy oncology group (RTOG 84–03). Int J Radiat Oncol Biol Phys 21:637–643PubMedCrossRefGoogle Scholar
- Strauss GM, Herndon JE, Sherman DD et al (2005) Neoadjuvant chemotherapy and radiotherapy followed by surgery in stage III non-small cell carcinoma of the lung: a report of a cancer and leukemia group B phase II study. J Clin Oncol 10:1237–1244Google Scholar
- Wade DT (1992) Measurement in neurological rehabilitation. Oxford University Press, NYGoogle Scholar