Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era
Abstract Background We investigated the role of prophylactic cranial irradiation (PCI) in limited‐stage small‐cell lung cancer (LS‐SCLC) according to tumor response in the magnetic resonance imaging (MRI) era. Methods We retrospectively evaluated patients with LS‐SCLC without brain metastases (BMs)...
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Wiley
2023-02-01
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| Series: | Cancer Medicine |
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| Online Access: | https://doi.org/10.1002/cam4.5082 |
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| author | Lihua Pan Xingwen Fan Lifang Wang Yihua Wang Yaqi Li Yingshan Cui Hong Zheng Qiong Yi Kailiang Wu |
| author_facet | Lihua Pan Xingwen Fan Lifang Wang Yihua Wang Yaqi Li Yingshan Cui Hong Zheng Qiong Yi Kailiang Wu |
| author_sort | Lihua Pan |
| collection | DOAJ |
| description | Abstract Background We investigated the role of prophylactic cranial irradiation (PCI) in limited‐stage small‐cell lung cancer (LS‐SCLC) according to tumor response in the magnetic resonance imaging (MRI) era. Methods We retrospectively evaluated patients with LS‐SCLC without brain metastases (BMs) on MRI who achieved either complete response (CR) or partial response (PR) after initial chemoradiotherapy at our center from 2006 to 2017. Results This study comprised 116 patients (median age, 58 years; men, 92; women, 24). After initial chemoradiotherapy, 53 patients achieved CR, while 63 patients achieved PR. Eighty‐three patients received PCI. Patients who received PCI had better overall survival (OS, 5‐year: 52.5% vs. 35.1%; p = 0.012) and progression‐free survival (PFS, 5‐year: 45.0% vs. 28.2%; p = 0.001) and a lower incidence of BMs (5‐year: 18.3% vs. 39.4%; p = 0.010). In the subgroup analysis, PCI improved OS (5‐year: 67.8% vs. 46.7%, p = 0.005) and PFS (5‐year: 65.2% vs. 35.0%, p = 0.021) and decreased BM risk (5‐year: 12.1% vs. 52.4%, p = 0.002) for patients with CR. However, PCI had no benefit (5‐year OS: 40.5% vs. 35.6%, p = 0.763; 5‐year BMs: 24.6% vs. 31.9%, p = 0.561) for patients with PR. Conclusions Tumor response remained an important factor for selecting patients for PCI in the MRI era. PCI should be recommended for patients with LS‐SCLC who achieve CR after initial thoracic chemoradiotherapy. |
| format | Article |
| id | doaj-art-c1877ecc62cf4a1284dd31d76f4e42af |
| institution | OA Journals |
| issn | 2045-7634 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj-art-c1877ecc62cf4a1284dd31d76f4e42af2025-08-20T02:33:05ZengWileyCancer Medicine2045-76342023-02-011232484249210.1002/cam4.5082Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging eraLihua Pan0Xingwen Fan1Lifang Wang2Yihua Wang3Yaqi Li4Yingshan Cui5Hong Zheng6Qiong Yi7Kailiang Wu8Department of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Oncology Affiliated Hospital of Jining Medical University Jining Shandong ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaDepartment of Radiation Oncology Fudan University Shanghai Cancer Center Shanghai ChinaAbstract Background We investigated the role of prophylactic cranial irradiation (PCI) in limited‐stage small‐cell lung cancer (LS‐SCLC) according to tumor response in the magnetic resonance imaging (MRI) era. Methods We retrospectively evaluated patients with LS‐SCLC without brain metastases (BMs) on MRI who achieved either complete response (CR) or partial response (PR) after initial chemoradiotherapy at our center from 2006 to 2017. Results This study comprised 116 patients (median age, 58 years; men, 92; women, 24). After initial chemoradiotherapy, 53 patients achieved CR, while 63 patients achieved PR. Eighty‐three patients received PCI. Patients who received PCI had better overall survival (OS, 5‐year: 52.5% vs. 35.1%; p = 0.012) and progression‐free survival (PFS, 5‐year: 45.0% vs. 28.2%; p = 0.001) and a lower incidence of BMs (5‐year: 18.3% vs. 39.4%; p = 0.010). In the subgroup analysis, PCI improved OS (5‐year: 67.8% vs. 46.7%, p = 0.005) and PFS (5‐year: 65.2% vs. 35.0%, p = 0.021) and decreased BM risk (5‐year: 12.1% vs. 52.4%, p = 0.002) for patients with CR. However, PCI had no benefit (5‐year OS: 40.5% vs. 35.6%, p = 0.763; 5‐year BMs: 24.6% vs. 31.9%, p = 0.561) for patients with PR. Conclusions Tumor response remained an important factor for selecting patients for PCI in the MRI era. PCI should be recommended for patients with LS‐SCLC who achieve CR after initial thoracic chemoradiotherapy.https://doi.org/10.1002/cam4.5082brain metastasiscranial irradiationmagnetic resonance imagingsmall cell lung cancersurvival |
| spellingShingle | Lihua Pan Xingwen Fan Lifang Wang Yihua Wang Yaqi Li Yingshan Cui Hong Zheng Qiong Yi Kailiang Wu Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era Cancer Medicine brain metastasis cranial irradiation magnetic resonance imaging small cell lung cancer survival |
| title | Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era |
| title_full | Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era |
| title_fullStr | Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era |
| title_full_unstemmed | Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era |
| title_short | Prophylactic cranial irradiation for limited‐stage small‐cell lung cancer in the magnetic resonance imaging era |
| title_sort | prophylactic cranial irradiation for limited stage small cell lung cancer in the magnetic resonance imaging era |
| topic | brain metastasis cranial irradiation magnetic resonance imaging small cell lung cancer survival |
| url | https://doi.org/10.1002/cam4.5082 |
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