PMID- 22782333
OWN - NLM
STAT- MEDLINE
DCOM- 20130429
LR  - 20240229
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Print)
IS  - 0923-7534 (Linking)
VI  - 23
IP  - 11
DP  - 2012 Nov
TI  - Prophylactic cranial irradiation in small-cell lung cancer: findings from a North 
      Central Cancer Treatment Group Pooled Analysis.
PG  - 2919-2924
LID - S0923-7534(19)37518-0 [pii]
LID - 10.1093/annonc/mds123 [doi]
AB  - BACKGROUND: This pooled analysis evaluated the outcomes of prophylactic cranial 
      irradiation (PCI) in 739 small-cell lung cancer (SCLC patients with stable 
      disease (SD) or better following chemotherapy +/- thoracic radiation therapy (TRT) 
      to examine the potential advantage of PCI in a wider spectrum of patients than 
      generally participate in PCI trials. PATIENTS AND METHODS: Three hundred eighteen 
      patients with extensive SCLC (ESCLC) and 421 patients with limited SCLC (LSCLC) 
      participated in four phase II or III trials. Four hundred fifty-nine patients 
      received PCI (30 Gy/15 or 25 Gy/10) and 280 did not. Survival and adverse events 
      (AEs) were compared. RESULTS: PCI patients survived significantly longer than 
      non-PCI patients hazard ratio [HR] = 0.61 [95% confidence interval (CI): 
      0.52-0.72]; P < 0.0001. The 1- and 3-year survival rates were 56% and 18% for 
      PCI patients versus 32% and 5% for non-PCI patients. PCI was still significant 
      after adjusting for age, performance status, gender, stage, complete response, 
      and number of metastatic sites (HR = 0.82, P = 0.04). PCI patients had 
      significantly more grade 3+ AEs (64%) compared with non-PCI patients (50%) (P = 
      0.0004). AEs associated with PCI included alopecia and lethargy. Dose 
      fractionation could be compared only for LSCLC patients and 25 Gy/10 was 
      associated with significantly better survival compared with 30 Gy/15 (HR = 0.67, 
      P = 0.018). CONCLUSIONS: PCI was associated with a significant survival benefit 
      for both ESCLC and LSCLC patients who had SD or a better response to chemotherapy 
      +/- TRT. Dose fractionation appears important. PCI was associated with an increase 
      in overall and specific grade 3+ AE rates.
FAU - Schild, S E
AU  - Schild SE
AD  - Department of Radiation Oncology, Mayo Clinic, Scottsdale. Electronic address: 
      sschild@mayo.edu.
FAU - Foster, N R
AU  - Foster NR
AD  - Section of Biomedical Statistics and Informatics, Mayo Clinic, Rochester.
FAU - Meyers, J P
AU  - Meyers JP
AD  - Section of Biomedical Statistics and Informatics, Mayo Clinic, Rochester.
FAU - Ross, H J
AU  - Ross HJ
AD  - Division of Medical Oncology, Mayo Clinic.
FAU - Stella, P J
AU  - Stella PJ
AD  - Michigan Cancer Research Consortium, Ann Arbor.
FAU - Garces, Y I
AU  - Garces YI
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester.
FAU - Olivier, K R
AU  - Olivier KR
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester.
FAU - Molina, J R
AU  - Molina JR
AD  - Department of Medical Oncology, Mayo Clinic, Rochester.
FAU - Past, L R
AU  - Past LR
AD  - Department of Radiation Oncology, Luther Hospital Eau Claire.
FAU - Adjei, A A
AU  - Adjei AA
AD  - Department of Radiation Oncology, Mayo Clinic, Rochester.
CN  - North Central Cancer Treatment Group
LA  - eng
GR  - CA-37404/CA/NCI NIH HHS/United States
GR  - CA-35431/CA/NCI NIH HHS/United States
GR  - CA-35090/CA/NCI NIH HHS/United States
GR  - CA-35195/CA/NCI NIH HHS/United States
GR  - CA-35103/CA/NCI NIH HHS/United States
GR  - CA-25224/CA/NCI NIH HHS/United States
GR  - CA-35113/CA/NCI NIH HHS/United States
GR  - CA-63848/CA/NCI NIH HHS/United States
GR  - CA-35119/CA/NCI NIH HHS/United States
GR  - CA-35415/CA/NCI NIH HHS/United States
GR  - CA-35101/CA/NCI NIH HHS/United States
GR  - CA-35267/CA/NCI NIH HHS/United States
GR  - CA-63849/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20120710
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cranial Irradiation
MH  - Disease-Free Survival
MH  - Dose Fractionation, Radiation
MH  - Humans
MH  - Lung Neoplasms/drug therapy/mortality/*radiotherapy
MH  - Middle Aged
MH  - Small Cell Lung Carcinoma/drug therapy/mortality/*radiotherapy
MH  - Survival Rate
MH  - Treatment Outcome
PMC - PMC3577038
EDAT- 2012/07/12 06:00
MHDA- 2013/04/30 06:00
PMCR- 2013/11/01
CRDT- 2012/07/12 06:00
PHST- 2012/07/12 06:00 [entrez]
PHST- 2012/07/12 06:00 [pubmed]
PHST- 2013/04/30 06:00 [medline]
PHST- 2013/11/01 00:00 [pmc-release]
AID - S0923-7534(19)37518-0 [pii]
AID - mds123 [pii]
AID - 10.1093/annonc/mds123 [doi]
PST - ppublish
SO  - Ann Oncol. 2012 Nov;23(11):2919-2924. doi: 10.1093/annonc/mds123. Epub 2012 Jul 
      10.