• The lancet oncology · Jul 2016

    Review

    Prophylactic cranial irradiation for patients with lung cancer.

    • Department of Radiation Oncology, Gustave Roussy University Hospital, Villejuif, France. Electronic address: cecile.lepechoux@gustaveroussy.fr.
    • Lancet Oncol. 2016 Jul 1; 17 (7): e277-e293.

    AbstractThe incidence of brain metastases in patients with lung cancer has increased as a result of improved local and systemic control and better diagnosis from advances in brain imaging. Because brain metastases are responsible for life-threatening symptoms and serious impairment of quality of life, resulting in shortened survival, prophylactic cranial irradiation has been proposed in both small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) to try to improve incidence of brain metastasis, survival, and eventually quality of life. Findings from randomised controlled trials and a meta-analysis have shown that prophylactic cranial irradiation not only reduces the incidence of brain metastases in patients with SCLC and with non-metastatic NSCLC, but also improves overall survival in patients with SCLC who respond to first-line treatment. Although prophylactic cranial irradiation is potentially associated with neurocognitive decline, this risk needs to be balanced against the potential benefit in terms of brain metastases incidence and survival. Several strategies to reduce neurotoxicity are being investigated.Copyright © 2016 Elsevier Ltd. All rights reserved.

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