Application of prophylactic cranial irradiation in limited-stage small-cell lung cancer: which patients could benefit?

Future Oncol. 2019 Jan;15(1):3237-3245. doi: 10.2217/fon-2018-0481. Epub 2018 Aug 9.

Abstract

Aim: To analyze the role of prophylactic cranial irradiation (PCI) on the survival for patients with limited-stage small-cell lung cancer (LS-SCLC).

Patients & methods: We screened patients from SEER database. Kaplan-Meier analysis and Cox proportional hazard model were used to evaluate factors influencing survival.

Results: LS-SCLC patients who receiving PCI were associated with better overall survival (OS; p < 0.001) and cancer-specific survival (CSS; p < 0.001). Multivariable Cox analysis revealed PCI was an independent prognostic factor for OS (p < 0.001) and CSS (p < 0.001). In subgroup analysis, there were no OS and CSS differences between PCI and no PCI groups in black patients and patient with a tumor size <5 cm (all p > 0.05).

Conclusion: PCI remains an effective method for most LS-SCLC patients. However, caution should be taken in recommending PCI for black patients and patients with a tumor size <5 cm. Further clinical trials are necessary to validate our results and identify the most suitable patients for PCI in the modern era.

Keywords: LS-SCLC; PCI; SEER; prognostic factors; survival.

MeSH terms

  • Brain Neoplasms / prevention & control*
  • Cranial Irradiation / methods*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / therapy
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Retrospective Studies
  • Small Cell Lung Carcinoma / mortality
  • Small Cell Lung Carcinoma / pathology*
  • Small Cell Lung Carcinoma / therapy
  • Treatment Outcome