Title |
Management of brain metastasis with magnetic resonance imaging and stereotactic irradiation attenuated benefits of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer
|
---|---|
Published in |
BMC Cancer, August 2015
|
DOI | 10.1186/s12885-015-1593-2 |
Pubmed ID | |
Authors |
Yuichi Ozawa, Minako Omae, Masato Fujii, Takashi Matsui, Masato Kato, Shinya Sagisaka, Kazuhiro Asada, Masato Karayama, Toshihiro Shirai, Kazumasa Yasuda, Yutaro Nakamura, Naoki Inui, Kazunari Yamada, Koshi Yokomura, Takafumi Suda |
Abstract |
Magnetic resonance imaging (MRI) enables a more sensitive detection of brain metastasis and stereotactic irradiation (SRI) efficiently controls brain metastasis. In limited-stage small cell lung cancer (LS-SCLC), prophylactic cranial irradiation (PCI) in patients with good responses to initial treatment is recommended based on the survival benefit shown in previous clinical trials. However, none of these trials evaluated PCI effects using the management of brain metastasis with MRI or SRI. This study aimed to determine the effects of MRI and SRI on the benefits of PCI in patients with LS-SCLC. The clinical records of pathologically proven SCLC from January 2006 to June 2013 in facilities equipped with or had access to SRI in Japan were retrospectively reviewed. Patients with LS-SCLC and complete or good partial responses after initial treatment were included in the study and analyzed by the Kaplan-Meier method. Of 418 patients with SCLC, 124 met criteria and were divided into patients receiving PCI (PCI group; n = 29) and those without PCI (non-PCI groups; n = 95). At baseline, ratios of patients with stage III were significantly advantageous for the non-PCI group, although younger age and high ratios of complete response and MRI confirmed absence of brain metastasis were advantageous for the PCI group. Neither median survival times (25 vs. 34 months; p = 0.256) nor cumulative incidence of brain metastasis during 2 years (45.5 vs. 30.8 %; p = 0.313) significantly differed between the two groups. Moreover, these factors did not significantly differ among patients with stage III disease (25 vs. 26 months; p = 0.680, 42.3 vs. 52.3 %; p = 0.458, respectively). PCI may be less beneficial in patients with LS-SCLC if the management with MRI and SRI is available. |
Twitter Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Portugal | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 1 | 50% |
Practitioners (doctors, other healthcare professionals) | 1 | 50% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Japan | 1 | 2% |
Unknown | 43 | 98% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 6 | 14% |
Other | 4 | 9% |
Student > Ph. D. Student | 4 | 9% |
Student > Master | 4 | 9% |
Student > Postgraduate | 2 | 5% |
Other | 7 | 16% |
Unknown | 17 | 39% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 18 | 41% |
Nursing and Health Professions | 3 | 7% |
Unspecified | 1 | 2% |
Biochemistry, Genetics and Molecular Biology | 1 | 2% |
Social Sciences | 1 | 2% |
Other | 1 | 2% |
Unknown | 19 | 43% |