Oncotarget

Research Papers:

Efficacy of prophylactic cranial irradiation in patients with limited-disease small-cell lung cancer who were confirmed to have no brain metastasis via magnetic resonance imaging after initial chemoradiotherapy

Nobuaki Mamesaya, Kazushige Wakuda _, Katsuhiro Omae, Eriko Miyawaki, Mie Kotake, Takumi Fujiwara, Takahisa Kawamura, Haruki Kobayashi, Kazuhisa Nakashima, Shota Omori, Akira Ono, Hirotsugu Kenmotsu, Tateaki Naito, Haruyasu Murakami, Keita Mori, Hideyuki Harada, Masahiro Endo, Takashi Nakajima and Toshiaki Takahashi

PDF  |  HTML  |  Supplementary Files  |  How to cite

Oncotarget. 2018; 9:17664-17674. https://doi.org/10.18632/oncotarget.24830

Metrics: PDF 1565 views  |   HTML 2416 views  |   ?  


Abstract

Nobuaki Mamesaya1, Kazushige Wakuda1, Katsuhiro Omae2, Eriko Miyawaki1, Mie Kotake1, Takumi Fujiwara1, Takahisa Kawamura1, Haruki Kobayashi1, Kazuhisa Nakashima1, Shota Omori1, Akira Ono1, Hirotsugu Kenmotsu1, Tateaki Naito1, Haruyasu Murakami1, Keita Mori2, Hideyuki Harada3, Masahiro Endo4, Takashi Nakajima5 and Toshiaki Takahashi1

1Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan

2Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan

3Division of Radiation Therapy, Shizuoka Cancer Center, Shizuoka, Japan

4Division of Diagnostic Radiology, Shizuoka Cancer Center, Shizuoka, Japan

5Division of Pathology, Shizuoka Cancer Center, Shizuoka, Japan

Correspondence to:

Kazushige Wakuda, email: [email protected]

Keywords: small-cell lung cancer; limited disease; prophylactic cranial irradiation; brain metastases

Received: November 21, 2017     Accepted: March 02, 2018     Published: April 03, 2018

ABSTRACT

Background: Prophylactic cranial irradiation (PCI) is recommended for patients with limited-disease small-cell lung cancer (LD-SCLC) who achieved good response to definitive chemoradiotherapy. However, most clinical studies lacked brain imaging scans before PCI. Our study aimed to investigate whether PCI has a survival benefit in patients who have no brain metastases (BM) confirmed via magnetic resonance imaging (MRI) before PCI.

Results: Eighty patients were included in this study. Sixty patients received PCI (PCI group) and 20 patients did not (non-PCI group). OS was not significantly different between the two groups. The median OS time was 4.3 years (95% CI: 2.6 years–8.6 years) in the PCI group and was not reached (NR) (95% CI: 1.9 years–NR) in the non-PCI group (p = 0.542). Moreover, no differences were observed in the 3-year rates of PFS (46.2% and 44.4%, p = 0.720) and cumulative incidence of BM (24.0% vs. 27%, p = 0.404).

Conclusions: Our result suggests that PCI may not have a survival benefit in patients with LD-SCLC confirmed to have no BM after initial therapy, even if patients achieve a good response to definitive chemoradiotherapy.

Patients and Methods: We retrospectively evaluated patients with LD-SCLC who were confirmed to have no BM via MRI after initial chemoradiotherapy at the Shizuoka Cancer Center between September 2002 and August 2015. The overall survival (OS), progression-free survival (PFS), and cumulative incidence of BM were estimated using the Kaplan–Meier method between patients who received PCI and those who did not. Propensity score matching was used to balance baseline characteristics.


Creative Commons License All site content, except where otherwise noted, is licensed under a Creative Commons Attribution 4.0 License.
PII: 24830