Prophylactic Brain Irradiation Helps in Small-Cell Lung Cancer

The one-year risk of brain metastases is 14.6 percent with irradiation versus 40.4 in controls

WEDNESDAY, Aug. 15 (HealthDay News) -- Prophylactic cranial irradiation in patients with extensive small-cell lung cancer reduces the incidence of symptomatic brain metastases and prolongs overall survival, according to the results of a randomized controlled trial published in the Aug. 16 issue of the New England Journal of Medicine.

Ben Slotman, M.D., Ph.D., of VU University Medical Center in Amsterdam, the Netherlands, and colleagues randomized 286 patients with extensive small-cell lung cancer to receive either prophylactic cranial irradiation or to receive no further therapy. The primary outcome measured was time to symptomatic brain metastases, which were diagnosed by computed tomography or magnetic resonance imaging.

The irradiation group had a lower risk of symptomatic brain metastases, with cumulative one-year risk of 14.6 percent in the irradiation group versus 40.4 percent in the control group. Disease-free survival was prolonged in the irradiation group (median 14.7 weeks versus 12.0 in the control group). Overall survival was increased (6.7 months for irradiation versus 5.4 months for controls). Cranial irradiation was well-tolerated and did not significantly impact global health status.

"Prophylactic cranial irradiation should be part of standard care for all patients with small-cell lung cancer who have a response to initial chemotherapy, and it should be part of the standard treatment in future studies involving these patients," the authors conclude.

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