© 2005-2012 American Society of Clinical Oncology (ASCO). All rights reserved worldwide.
June 2, 2007
A report from Dutch researchers shows that giving radiation therapy to the head lowers the risk of the spread of cancer to the brain and helps patients with extensive-stage small cell lung cancer live longer.
Small cell lung cancer makes up about 15% of lung cancers and is described as either limited stage (the cancer is located on one side of the chest) or extensive stage (the cancer has spread to other areas of the chest or outside of the chest). Patients with extensive-stage cancer are usually treated with chemotherapy, but the risk of the cancer spreading to the brain is high. Prophylactic cranial irradiation (PCI, preventive radiation therapy) is used to treat patients with limited-stage small cell lung cancer. This is the first study to evaluate PCI in patients with extensive-stage cancer.
Researchers evaluated 286 patients with extensive-stage small cell lung cancer whose tumors shrank in response to chemotherapy. Half of the patients received PCI, and half received no PCI. PCI was given daily for one to two weeks at doses comparable to those used to treat cancer that has already spread to the brain.
One year later, only 15% of the patients that received PCI had symptoms indicating that the cancer had spread to the brain, compared with 40% of the patients who did not receive PCI. Moreover, 27% of the patients receiving PCI were alive after one year, compared with 13% of the other patients. PCI was associated with mild side effects that included nausea, vomiting, and headache, reported by 30% of patients.
What This Means for Patients
"Our data suggest that all patients with extensive-stage small cell lung cancer that responds to chemotherapy could benefit from PCI," said lead author Ben Slotman, MD, PhD, Professor and Chairman of Radiation Oncology at VU University Medical Center in Amsterdam. "Because improvements in the treatment for patients with advanced small cell lung cancer have been minimal in the past two decades, these findings are important."