Follow-up neurological evaluation in patients with small cell lung carcinoma treated with prophylactic cranial irradiation and chemotherapy

Journal Article · Thu Jan 01 04:00:00 EST 1981 · Int. J. Radiat. Oncol., Biol. Phys.; (United States)

DOI:https://doi.org/10.1016/0360-3016(81)90066-3· OSTI ID:6643379

Catane, R; Schwade, J G; Yarr, I; Licher, A S; Tepper, J E; Dunnick, N R; Brody, L; Brereton, H D; Cohen, M; Glatstein, E

The safety of prophylactic cranial irradiation (PCI) has recently been questioned, based on reports of computerized tomographic abnormalities mainly seen in children, who received PCI and chemotherapy, primarily for acute lymphocytic leukemia. In order to clarify the significance of these findings, we examined a series of adult patients who were long term survivors (18 to 48 months, median 26 months, after all treatment). These patients were treated with combination radiotherapy and chemotherapy for small cell lung carcinoma and received cranial irradiation in the absence of known brain involvement by tumor. Patients were divided into three groups: three patients who received PCI + intrathecal methotrexate (MTX) (Group 1), and ten who received only PCI (Group 2). An additional three patients (Group 3) were identified as long term survivors (41 to 70 months after all treatments) of a similar treatment program without any central nervous system (CNS) prophylaxis. All patients received an extensive evaluation of a variety of clinical parameters, EEG, and computer tomography (CT). Although CT abnormalities were detectable (mild cerebral atrophy in eight patients, encephalomalacia in one of the 13 patients with CNS prophylaxis, and mild atrophy in two of the three patients without CNS prophylaxis), no significant clinical abnormalities or EEG changes were detectable. While this group of patients is small, it is a unique cohort: adults who have received cranial irradiation in the absence of known brain tumor with long term follow-up. The precise role of CNS prophylaxis in the etiology of CT abnormalities is unclear, and the lack of clinically significant changes would suggest no contraindication to PCI when indicated.

• OSTI ID: 6643379
• Journal Information: Int. J. Radiat. Oncol., Biol. Phys.; (United States), Journal Name: Int. J. Radiat. Oncol., Biol. Phys.; (United States) Vol. 7:1; ISSN IOBPD
• Country of Publication: United States
• Language: English

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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
CHEMOTHERAPY
COMPUTERIZED TOMOGRAPHY
DELAYED RADIATION EFFECTS
DIAGNOSTIC TECHNIQUES
DISEASES
DOSES
ELECTROENCEPHALOGRAPHY
EXTERNAL IRRADIATION
IRRADIATION
LUNGS
MEDICAL SURVEILLANCE
MEDICINE
NEOPLASMS
NERVOUS SYSTEM
NUCLEAR MEDICINE
ORGANS
PATIENTS
PREVENTIVE MEDICINE
RADIATION DOSES
RADIATION EFFECTS
RADIOLOGY
RADIOSENSITIVITY
RADIOTHERAPY
RESPIRATORY SYSTEM
SIDE EFFECTS
SURVEILLANCE
THERAPY
TOMOGRAPHY