Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes

Farkhad Manapov,1,2 Lukas Käsmann,1 Olarn Roengvoraphoj,1 Maurice Dantes,1 Nina-Sophie Schmidt-Hegemann,1 Claus Belka,1,2 Chukwuka Eze1 1Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; 2Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany Abstr...

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Autores principales:	Manapov F, Käsmann L, Roengvoraphoj O, Dantes M, Schmidt-Hegemann NS, Belka C, Eze C
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2018
Materias:	PCI small cell lung cancer treatment patient selection neurocognition Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/d532703350be43178d992d7ac453a563
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spelling	oai:doaj.org-article:d532703350be43178d992d7ac453a5632021-12-02T02:25:19ZProphylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes1179-2728https://doaj.org/article/d532703350be43178d992d7ac453a5632018-08-01T00:00:00Zhttps://www.dovepress.com/prophylactic-cranial-irradiation-in-small-cell-lung-cancer-update-on-p-peer-reviewed-article-LCTThttps://doaj.org/toc/1179-2728Farkhad Manapov,1,2 Lukas Käsmann,1 Olarn Roengvoraphoj,1 Maurice Dantes,1 Nina-Sophie Schmidt-Hegemann,1 Claus Belka,1,2 Chukwuka Eze1 1Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; 2Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany Abstract: Over 10% of small-cell lung cancer (SCLC) patients have brain metastases (BM) at initial diagnosis; more than 50% will develop BM within 2 years. BM are detected in up to 80% of all patients at autopsy. After primary treatment, prophylactic cranial irradiation (PCI) has been established as standard of care in SCLC patients responding to initial therapy. Based on level I evidence, PCI significantly decreases the risk of intracranial relapse and shows a modest survival benefit after 3 years. However, the role of PCI in defined patient subgroups such as resected SCLC, elderly and extensive stage patients with access to magnetic resonance imaging surveillance and stereotactic radiotherapy is yet to be fully clarified. Furthermore, strategies to effective prevention of neurocognitive decline after PCI remain unclear. All these factors significantly impact treatment decision making and should be evaluated in prospective settings. New concepts such as hippocampal avoidance and drug neuroprotection prevent chronic neurocognitive effects reducing treatment-related side effects of PCI. The aim of this review is to present a summary and update of the latest evidence for patient selection, efficacy and outcome of PCI. Keywords: PCI, small-cell lung cancer, treatment, patient selection, neurocognitionManapov FKäsmann LRoengvoraphoj ODantes MSchmidt-Hegemann NSBelka CEze CDove Medical PressarticlePCIsmall cell lung cancertreatmentpatient selectionneurocognitionNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENLung Cancer: Targets and Therapy, Vol Volume 9, Pp 49-55 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	PCI small cell lung cancer treatment patient selection neurocognition Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	PCI small cell lung cancer treatment patient selection neurocognition Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Manapov F Käsmann L Roengvoraphoj O Dantes M Schmidt-Hegemann NS Belka C Eze C Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
description	Farkhad Manapov,1,2 Lukas Käsmann,1 Olarn Roengvoraphoj,1 Maurice Dantes,1 Nina-Sophie Schmidt-Hegemann,1 Claus Belka,1,2 Chukwuka Eze1 1Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany; 2Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany Abstract: Over 10% of small-cell lung cancer (SCLC) patients have brain metastases (BM) at initial diagnosis; more than 50% will develop BM within 2 years. BM are detected in up to 80% of all patients at autopsy. After primary treatment, prophylactic cranial irradiation (PCI) has been established as standard of care in SCLC patients responding to initial therapy. Based on level I evidence, PCI significantly decreases the risk of intracranial relapse and shows a modest survival benefit after 3 years. However, the role of PCI in defined patient subgroups such as resected SCLC, elderly and extensive stage patients with access to magnetic resonance imaging surveillance and stereotactic radiotherapy is yet to be fully clarified. Furthermore, strategies to effective prevention of neurocognitive decline after PCI remain unclear. All these factors significantly impact treatment decision making and should be evaluated in prospective settings. New concepts such as hippocampal avoidance and drug neuroprotection prevent chronic neurocognitive effects reducing treatment-related side effects of PCI. The aim of this review is to present a summary and update of the latest evidence for patient selection, efficacy and outcome of PCI. Keywords: PCI, small-cell lung cancer, treatment, patient selection, neurocognition
format	article
author	Manapov F Käsmann L Roengvoraphoj O Dantes M Schmidt-Hegemann NS Belka C Eze C
author_facet	Manapov F Käsmann L Roengvoraphoj O Dantes M Schmidt-Hegemann NS Belka C Eze C
author_sort	Manapov F
title	Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
title_short	Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
title_full	Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
title_fullStr	Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
title_full_unstemmed	Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
title_sort	prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes
publisher	Dove Medical Press
publishDate	2018
url	https://doaj.org/article/d532703350be43178d992d7ac453a563
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Prophylactic cranial irradiation in small-cell lung cancer: update on patient selection, efficacy and outcomes

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