In a nutshell
In this review, the authors aimed to assess the beneficial role of preventive radiation therapy to the head in small cell lung cancer (SCLC).
Some background
SCLC accounts for 13% of all lung cancers. It tends to grow and spread quickly to other parts of the body, often to the brain (brain metastasis). The available treatment options, chemotherapy and radiotherapy, fail to improve overall survival in SLCL patients with brain metastasis. Chemotherapy drugs from blood circulation cannot reach the brain because circulating blood and the brain are separated by a tight lining of cells (blood-brain barrier) through which the drugs can not pass.
Prophylactic cranial irradiation (PCI) is preventive radiation therapy to the head. PCI kills the cancer cells that may have already spread to the brain but are not seen yet by scans. Previous studies showed that PCI significantly lowered the occurence of brain metastasis in SCLC.
Methods & findings
The authors reviewed data from 5 clinical trials to analyze the effect of PCI on the occurence of brain metastasis and overall survival in SLCL.
In 2 of the trials reporting occurrence of brain metastasis, PCI reduced the risk of brain metastasis by 55% over 1 year period.
Overall survival was analyzed based on 1-year, 3-year or 5-year survival rate. Based on combined data from the clinical trials, the overall survival benefit was similar in both 1-year and 3-year survival rate groups. The risk of death was reduced by 13% in patients treated with PCI compared to no PCI in both the groups. For 5-year survival, the risk of death was reduced by 8% in patients with PCI compared to no PCI.
The bottom line
The authors concluded that PCI decreased the occurrence of brain metastasis and improved overall survival in SCLC patients. The authors stated that PCI should be considered as standard care for any patient with SCLC who has an initial response to chemotherapy.
Published By :
BMC cancer
Date :
Oct 31, 2014
