Prophylactic Cranial Irradiation For Extensive-Stage Small Cell Lung Cancer: Analysis Based On Active Brain Mri Surveillance
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY(2020)
摘要
Background and purpose: The value of prophylactic cranial irradiation (PCI) for extensive-stage small-cell lung cancer (ES-SCLC) has recently been challenged. This study was conducted to evaluate the role of PCI for ES-SCLC under active brain magnetic resonance imaging (MRI) surveillance.Materials and methods: Patients with ES-SCLC who showed any responses after first-line chemotherapy and no initial brain metastasis (BM) were retrospectively included. Active brain MRI surveillance was performed for all patients. Progression-free survival (PFS) and overall survival (OS) were compared between PCI and non-PCI patients. The time-related hazard of BM was evaluated in non-PCI patients.Results: One hundred and eighteen consecutive patients were included in the study. The median followup time was 26.5 months (3-72 months). The median PFS and OS were better in the PCI cohort than in the non-PCI group. Multivariate analyses revealed first-line chemotherapy cycles ( 4 vs. < 4 cycles, HR: 0.29; 95% CI: 0.15-0.55, P < 0.01) and PCI (Yes vs. No, HR: 0.54; 95% CI: 0.29-0.99, P = 0.04) were independent prognostic factors for disease progression. In the non-PCI group, 47.4% (46/97) of the patients developed BM and the hazard of BM increased continuously in three-quarters of the first year since diagnosis.Conclusion: Under active brain MRI surveillance, PCI could be beneficial for patients with ES-SCLC who show good responses after first-line chemotherapy. (c) 2020 The Authors. Published by Elsevier B.V. on behalf of European Society for Radiotherapy and Oncology. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/).
更多查看译文
关键词
Prophylactic cranial irradiation, Extensive stage small-cell lung cancer, MRI surveillance
AI 理解论文
溯源树
样例
生成溯源树,研究论文发展脉络