Prophylactic Cranial Irradiation in Extensive Disease Small-Cell Lung Cancer: Short-Term Health-Related Quality of Life and Patient Reported Symptoms--Results of an International Phase III Randomized Controlled Trial by the EORTC Radiation Oncology and Lung Cancer Groups
Berend J. Slotman,Murielle Mauer,Andrew Bottomley,Corinne Faivre-Finn,G.W.P.M. Kramer,E.M. Rankin,Michael Snee,Matthew Hatton,Pieter E. Postmus,Laurence Collette,Suresh Senan +10 more
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Prophylactic cranial irradiation in patients with extensive-disease small-cell lung cancer (ED-SCLC) leads to significantly fewer symptomatic brain metastases and improved survival and PCI should be offered to all responding ED SCLC patients.Abstract:
Purpose Prophylactic cranial irradiation (PCI) in patients with extensive-disease small-cell lung cancer (ED-SCLC) leads to significantly fewer symptomatic brain metastases and improved survival. Detailed effects of PCI on health-related quality of life (HRQOL) are reported here. Patients and Methods Patients (age, 18 to 75 years; WHO 2) with ED-SCLC, and any response to chemotherapy, were randomly assigned to either observation or PCI. Health-related quality of life (HRQOL) and patient-reported symptoms were secondary end points. The European Organisation for the Research and Treatment of Cancer core HRQOL tool (Quality of Life Questionnaire C30) and brain module (Quality of Life Questionnaire Brain Cancer Module) were used to collect self-reported patient data. Six HRQOL scales were selected as primary HRQOL end points: global health status; hair loss; fatigue; and role, cognitive and emotional functioning. Assessments were performed at random assignment, 6 weeks, 3 months, and then 3-monthly up to 1 year and 6-monthly thereafter. Results Compliance with the HRQOL assessment was 93.7% at baseline and dropped to 60% at 6 weeks. Short-term results up to 3 months showed that there was a negative impact of PCI on selected HRQOL scales. The largest mean difference between the two arms was observed for fatigue and hair loss. The impact of PCI on global health status as well as on functioning scores was more limited. For global health status, the observed mean difference was eight points on a scale 0 to 100 at 6 weeks (P .018) and 3 months (P .055). Conclusion PCI should be offered to all responding ED SCLC patients. Patients should be informed of the potential adverse effects from PCI. Clinicians should be alert to these; monitor their patients; and offer appropriate support, clinical, and psychosocial care.read more
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A European Organisation for Research and Treatment of Cancer Phase III Trial of Adjuvant Whole-Brain Radiotherapy Versus Observation in Patients With One to Three Brain Metastases From Solid Tumors After Surgical Resection or Radiosurgery: Quality-of-Life Results
Riccardo Soffietti,Martin Kocher,Ufuk Abacioglu,Salvador Villà,François Fauchon,Brigitta G. Baumert,L. Fariselli,Tzahala Tzuk-Shina,Rolf-Dieter Kortmann,Christian Carrie,Mohamed Ben Hassel,Mauri Kouri,Egils Valeinis,Dirk van den Berge,Rolf P. Mueller,Gloria Tridello,Laurence Collette,Andrew Bottomley +17 more
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Small-cell lung cancer (SCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
TL;DR: This work presents the results of a meta-analysis conducted at the 2016 European Oncology Conference of Oncologists and Hematologists (ECMWG) at the invitation of the ESMO Guidelines Working Group on the basis of data presented at the 2015 European oncology conference.
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Small cell lung cancer.
Gregory P. Kalemkerian,Wallace Akerley,Robert J. Downey,David S. Ettinger,Frank V. Fossella,John C. Grecula,Thierry Jahan,Bruce E. Johnson,Anne Kessinger,Marianna Koczywas,Corey J. Langer,Renato G. Martins,Harvey B. Niell,Charles C. Pan,Nithya Ramnath,Neal Ready,Francisco Robert,Charles C. Williams +17 more
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Journal ArticleDOI
Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial.
Toshiaki Takahashi,Takeharu Yamanaka,Takashi Seto,Hideyuki Harada,Hiroshi Nokihara,Hideo Saka,Makoto Nishio,Hiroyasu Kaneda,Koichi Takayama,Osamu Ishimoto,Koji Takeda,Hiroshige Yoshioka,Motoko Tachihara,Hiroshi Sakai,Koichi Goto,Nobuyuki Yamamoto +15 more
TL;DR: Prophylactic cranial irradiation is therefore not essential for patients with extensive-disease small-cell lung cancer with any response to initial chemotherapy and a confirmed absence of brain metastases when patients receive periodic MRI examination during follow-up.
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Ramaswamy Govindan,Nathan C. Page,Daniel Morgensztern,William L. Read,Ryan M. Tierney,Anna Vlahiotis,Edward L. Spitznagel,Jay F. Piccirillo +7 more
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Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group.
Anne Auperin,Rodrigo Arriagada,J.P. Pignon,Le Péchoux C,A. Gregor,Richard Stephens,P. E.G. Kristjansen,B. E. Johnson,Hiroshi Ueoka,Henry N. Wagner,Joseph Aisner +10 more
TL;DR: Prophylactic cranial irradiation improves both overall survival and disease-free survival among patients with small-cell lung cancer in complete remission and identifies a trend toward a decrease in the risk of brain metastasis with earlier administration of cranials irradiation after the initiation of induction chemotherapy.
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Prophylactic Cranial Irradiation in Extensive Small-Cell Lung Cancer
Berend J. Slotman,Corinne Faivre-Finn,G.W.P.M. Kramer,E.M. Rankin,Michael Snee,Matthew Hatton,Pieter E. Postmus,Laurence Collette,Elena Musat,Suresh Senan +9 more
TL;DR: Prophylactic cranial irradiation reduces the incidence of symptomatic brain metastases and prolongs disease-free and overall survival and did not have a clinically significant effect on global health status.