Skip to main content

Advertisement

SpringerLink
Log in

Unexpected dementia following prophylactic cranial irradiation for small cell lung cancer: case report

  • Clinical-Patient Studies
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Object

Prophylactic cranial irradiation (PCI) is commonly offered to patients with limited stage primary small cell lung cancer following a complete response.

Methods

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.

Conclusions

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  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 341:476–484

    Article  PubMed  CAS  Google 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 7:105–109

    PubMed  CAS  Google Scholar 

  3. Lee JS, Umsawasdi T, Lee YY, Barkley HT, Jr. Murphy WK, Welch S, Valdivieso M (1986) Neurotoxicity in long-term survivors of small cell lung cancer. Int J Radiat Oncol Biol Phys 12:313–321

    PubMed  CAS  Google Scholar 

  4. Lishner M, Feld R, Payne DG, Sagman U, Sculier JP, Pringle JF, Yeoh JL, Evans WK, Shepherd FA, Maki E et al (1990) Late neurological complications after prophylactic cranial irradiation in patients with small-cell lung cancer: the Toronto experience. J Clin Oncol 8:215–221

    PubMed  CAS  Google 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 33:1752–1758

    Article  PubMed  CAS  Google Scholar 

  6. Arriagada R, Le Chevalier T, Borie F, Riviere A, Chomy P, Monnet I, Tardivon A, Viader F, Tarayre M, Benhamou S (1995) Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. J Natl Cancer Inst 87:183–190

    Article  PubMed  CAS  Google Scholar 

  7. Fleck JF, Einhorn LH, Lauer RC, Schultz SM, Miller ME (1990) Is prophylactic cranial irradiation indicated in small-cell lung cancer? J Clin Oncol 8:209–214

    PubMed  CAS  Google Scholar 

  8. Kalemkerian GP (2007) NCCN Practice Guidelines Small Cell Lung Cancer v.1

  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 340:265–271

    Article  PubMed  CAS  Google Scholar 

  10. DeAngelis LM, Delattre JY, Posner JB (1989) Radiation-induced dementia in patients cured of brain metastases. Neurology 39:789–796

    PubMed  CAS  Google Scholar 

  11. Komaki R, Meyers CA, Shin DM, Garden AS, Byrne K, Nickens JA, Cox JD (1995) Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation. Int J Radiat Oncol Biol Phys 33:179–182

    Article  PubMed  CAS  Google Scholar 

  12. Fonseca R, O’Neill BP, Foote RL, Grill JP, Sloan JA, Frytak S (1999) Cerebral toxicity in patients treated for small cell carcinoma of the lung. Mayo Clin Proc 74:461–465

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    David J. D’Ambrosio, Andre Konski, Mark K. Buyyounouski & Steven J. Feigenberg

  2. Department of Medical Oncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Roger B. Cohen

  3. Department of Neurooncology, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA

    Jon Glass

Authors
  1. David J. D’Ambrosio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roger B. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jon Glass
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andre Konski
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark K. Buyyounouski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Steven J. Feigenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Steven J. Feigenberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

D’Ambrosio, D.J., Cohen, R.B., Glass, J. et al. Unexpected dementia following prophylactic cranial irradiation for small cell lung cancer: case report. J Neurooncol 85, 77–79 (2007). https://doi.org/10.1007/s11060-007-9384-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11060-007-9384-5

Keywords

Search

Navigation