The role of prophylactic cranial irradiation in regionally advanced non-small cell lung cancer. A Southwest Oncology Group Study

Journal Article · Sun Oct 01 04:00:00 EDT 1989 · Journal of Thoracic and Cardiovascular Surgery; (USA)

OSTI ID:5225851

Rusch, V W; Griffin, B R; Livingston, R B ^[1]

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1. Univ. of Washington, Seattle (USA)

Lung cancer is the most common malignant disease in the United States. Only the few tumors detected very early are curable, but there has been some progress in the management of more advanced non-small cell lung cancer, particularly in regionally inoperable disease. Prevention of central nervous system relapse is an important issue in this group of patients because brain metastases ultimately develop in 20% to 25% of them. Seventy-three patients with regionally advanced non-small cell lung cancer were entered into a Phase II trial of neutron chest radiotherapy sandwiched between four cycles of chemotherapy including cisplatin, vinblastine, and mitomycin C. Prophylactic cranial irradiation was administered concurrently with chest radiotherapy (3000 cGy in 10 fractions in 15 patients; 3600 cGy in 18 fractions in the remaining 50 patients). Patients underwent computed tomographic scan of the brain before treatment and every 3 months after treatment. The initial overall response rate was 79%, but 65 of the 73 patients have subsequently died of recurrent disease. Median follow-up is 9 months for all 73 patients and 26 months for eight long-term survivors. No patient who completed the prophylactic cranial irradiation program had clinical or radiologic brain metastases. Toxic reactions to prophylactic cranial irradiation included reversible alopecia in all patients, progressive dementia in one patient, and possible optic neuritis in one patient. Both of these patients received 300 cGy per fraction of irradiation. The use of prophylactic cranial irradiation has been controversial, but its safety and efficacy in this trial supports its application in a group of patients at high risk for central nervous system relapse. Further evaluation of prophylactic cranial irradiation in clinical trials for regionally advanced non-small cell lung cancer is warranted.

• OSTI ID: 5225851
• Journal Information: Journal of Thoracic and Cardiovascular Surgery; (USA), Journal Name: Journal of Thoracic and Cardiovascular Surgery; (USA) Vol. 98:4; ISSN 0022-5223; ISSN JTCSA
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BRAIN
CENTRAL NERVOUS SYSTEM
CHEMOTHERAPY
COMBINED THERAPY
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
LUNGS
MEDICINE
METASTASES
NEOPLASMS
NERVOUS SYSTEM
NEUTRON THERAPY
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
THERAPY
TOMOGRAPHY