Risk of brain metastasis from small cell carcinoma of the lung related to length of survival and prophylactic irradiation

Journal Article · · Cancer Treat. Rep.; (United States)

OSTI ID:5365868

Komaki, R; Cox, J D; Whitson, W

The problem of brain metastasis from small cell carcinoma (SCC) of the lung has been appreciated for many years, but the magnitude of the problem has been underestimated. Recent studies have shown that the risk of brain metastasis increase as survival is prolonged. Although prophylactic cranial irradiation (PCI) has reduced the frequency of brain metastases, the effect on risk estimates of differences in the periods of observation was not evaluated. From 1974 through 1979, 131 patients with SCC of the lung who had no evidence of brain metastasis by radionuclide or computerized tomographic scan were treated in the Division of Therapeutic Radiology at the Medical College of Wisconsin Affiliated Hospitals. PCI was started in 1977; 57 patients received it and 74 did not. To correct for the differing periods of observation for the two groups, an actuarial calculation of the probability of brain metastasis was used. The calculated rate of clinical failure in the brain for patients who did not receive PCI was 28% at 12 months and 58% at 24 months. The calculated failure rate of the brain for patients who received PCI was 11% at 12 and 24 months. The difference in the probability of brain metastasis between the patients who did or did not receive PCI is highly significant (P less than 0.01). The true benefit of PCI becomes apparent only when the risk of intracranial metastasis is evaluated by methods that correct for incomplete followup. PCI eliminates the progressive increase in the risk of brain metastasis that accompanies increased survival and is important to maximize the probability for cure of patients with SCC.

• OSTI ID: 5365868
• Journal Information: Cancer Treat. Rep.; (United States), Journal Name: Cancer Treat. Rep.; (United States) Vol. 65:9-10; ISSN CTRRD
• Country of Publication: United States
• Language: English

Related Subjects

550603* -- Medicine-- External Radiation in Therapy-- (1980-)
550900 -- Pathology
560151 -- Radiation Effects on Animals-- Man
59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
BRAIN
CARCINOMAS
CENTRAL NERVOUS SYSTEM
DISEASES
IRRADIATION
LOCAL IRRADIATION
LUNGS
MEDICINE
METASTASES
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PATIENTS
PREVENTIVE MEDICINE
RADIATION EFFECTS
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SURVIVAL TIME
THERAPY
TIME DEPENDENCE