Ufuk Yılmaz1, Esra Korkmaz Kırakli2, Ümit Gürlek2, Yasemin Özdoğan1, Bahri Gümüş3, Salih Akşit3. 1. Department of Pulmonary Medicine, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey. 2. Department of Radiation Oncology, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey. 3. Department of Radiology, Dr. Suat Seren Chest Disease and Surgery Training and Research Hospital, İzmir, Turkey.
Abstract
OBJECTIVES: Prophylactic cranial irradiation (PCI) decreases incidence of brain metastasis and improves survival in patients with limited disease-small cell lung cancer (LD-SCLC) who achieved complete response (CR) after treatment. There is no satisfactory evidence about the necessity of new brain imaging for asymptomatic metastasis immediately prior to PCI. The present study aimed to evaluate the frequency of brain metastasis in SCLC patients without neurological symptoms who are candidates for PCI. MATERIAL AND METHODS: The data files of 243 patients with SCLC referred for cranial irradiation were retrospectively reviewed. The patients with following characteristics were enrolled to the study; 1) LD-SCLC patients with CR after chemoradiotherapy who are candidates for PCI. 2) No neurological signs or symptoms of brain metastasis after chemoradiotherapy. 3) Having brain imaging at initial diagnosis and before PCI. RESULTS: Ninety-nine patients (83 male, 83.3%) were included in this study. Median age was 60 years. Time interval between initial and reevaluation for brain metastasis was median 5.5 months (range; 4.7-7.1). Asymptomatic brain metastasis rate was 20.2% (18/99). CONCLUSION: Even if local disease is under control, asymptomatic brain metastasis is not rare. Therefore, patients who are candidates for PCI after completion of chemoradiotherapy should be reimaged for brain metastasis before PCI.
OBJECTIVES: Prophylactic cranial irradiation (PCI) decreases incidence of brain metastasis and improves survival in patients with limited disease-small cell lung cancer (LD-SCLC) who achieved complete response (CR) after treatment. There is no satisfactory evidence about the necessity of new brain imaging for asymptomatic metastasis immediately prior to PCI. The present study aimed to evaluate the frequency of brain metastasis in SCLCpatients without neurological symptoms who are candidates for PCI. MATERIAL AND METHODS: The data files of 243 patients with SCLC referred for cranial irradiation were retrospectively reviewed. The patients with following characteristics were enrolled to the study; 1) LD-SCLCpatients with CR after chemoradiotherapy who are candidates for PCI. 2) No neurological signs or symptoms of brain metastasis after chemoradiotherapy. 3) Having brain imaging at initial diagnosis and before PCI. RESULTS: Ninety-nine patients (83 male, 83.3%) were included in this study. Median age was 60 years. Time interval between initial and reevaluation for brain metastasis was median 5.5 months (range; 4.7-7.1). Asymptomatic brain metastasis rate was 20.2% (18/99). CONCLUSION: Even if local disease is under control, asymptomatic brain metastasis is not rare. Therefore, patients who are candidates for PCI after completion of chemoradiotherapy should be reimaged for brain metastasis before PCI.
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Authors: A Gregor; A Cull; R J Stephens; J A Kirkpatrick; J R Yarnold; D J Girling; F R Macbeth; R Stout; D Machin Journal: Eur J Cancer Date: 1997-10 Impact factor: 9.162
Authors: A P Meert; M Paesmans; T Berghmans; B Martin; C Mascaux; F Vallot; J M Verdebout; J J Lafitte; J P Sculier Journal: BMC Cancer Date: 2001-06-19 Impact factor: 4.430