Re-evaluation of prophylactic cranial irradiation in limited-stage small cell lung cancer: a propensity score matched analysis

Abstract We attempted to re-evaluate the efficacy of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC) with more recent data. A total of 179 patients with LS-SCLC received radical thoracic radiotherapy and chemotherapy at our institution between 1998 and 2018....

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Veröffentlicht in:Journal of radiation research 2021-09, Vol.62 (5), p.877-883
Hauptverfasser: Inoue, Yuko, Tsujino, Kayoko, Sulaiman, Nor Shazrina, Marudai, Mitsuru, Kajihara, Akifumi, Miyazaki, Shuichiro, Sekii, Shuhei, Uezono, Haruka, Ota, Yousuke, Soejima, Toshinori
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container_issue 5
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container_title Journal of radiation research
container_volume 62
creator Inoue, Yuko
Tsujino, Kayoko
Sulaiman, Nor Shazrina
Marudai, Mitsuru
Kajihara, Akifumi
Miyazaki, Shuichiro
Sekii, Shuhei
Uezono, Haruka
Ota, Yousuke
Soejima, Toshinori
description Abstract We attempted to re-evaluate the efficacy of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC) with more recent data. A total of 179 patients with LS-SCLC received radical thoracic radiotherapy and chemotherapy at our institution between 1998 and 2018. One hundred twenty-eight patients who achieved complete response (CR), good partial response (PR), and PR without progression for at least for one year after initial therapy were enrolled in this study. These patients were divided into a PCI group (group A, n = 43), and a non-PCI group (group B, n = 85). Survival outcomes were retrospectively evaluated. Because several background factors differed significantly between groups A and B, propensity score (PS) matching was performed as 1:1 match of the two groups. Finally, we analyzed 64 patients (group A/B = 32/32). Median follow-up periods were 53 and 31 months in groups A and B, respectively. There were no significant differences between the groups’ backgrounds. Two-year overall survival (OS) rates were 77% in group A and 62% in group B (p = 0.224). Two-year brain metastasis free survival (BMFS) rates were 85% in group A and 57% in group B (p = 0.008). The number of patients who underwent a brain imaging test for confirmation of no brain metastasis (BM) after radical thoracic radiotherapy and chemotherapy (before PCI) was 84 (group A/B = 32/52). A PS matched analysis for cases of pre-PCI brain imaging group, two-year OS rates for group A/B were 73/59% (p = 0.446). Two-year BMFS rates for group A/B were 91/52% (p = 0.021). Retrospectively, PS matched analysis revealed that adding PCI to LS-SCLC patients who achieved good thoracic control significantly improved BMFS, but OS did not improve.
doi_str_mv 10.1093/jrr/rrab053
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A total of 179 patients with LS-SCLC received radical thoracic radiotherapy and chemotherapy at our institution between 1998 and 2018. One hundred twenty-eight patients who achieved complete response (CR), good partial response (PR), and PR without progression for at least for one year after initial therapy were enrolled in this study. These patients were divided into a PCI group (group A, n = 43), and a non-PCI group (group B, n = 85). Survival outcomes were retrospectively evaluated. Because several background factors differed significantly between groups A and B, propensity score (PS) matching was performed as 1:1 match of the two groups. Finally, we analyzed 64 patients (group A/B = 32/32). Median follow-up periods were 53 and 31 months in groups A and B, respectively. There were no significant differences between the groups’ backgrounds. Two-year overall survival (OS) rates were 77% in group A and 62% in group B (p = 0.224). Two-year brain metastasis free survival (BMFS) rates were 85% in group A and 57% in group B (p = 0.008). The number of patients who underwent a brain imaging test for confirmation of no brain metastasis (BM) after radical thoracic radiotherapy and chemotherapy (before PCI) was 84 (group A/B = 32/52). A PS matched analysis for cases of pre-PCI brain imaging group, two-year OS rates for group A/B were 73/59% (p = 0.446). Two-year BMFS rates for group A/B were 91/52% (p = 0.021). 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control</topic><topic>Small Cell Lung Carcinoma - secondary</topic><topic>Small Cell Lung Carcinoma - therapy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Inoue, Yuko</creatorcontrib><creatorcontrib>Tsujino, Kayoko</creatorcontrib><creatorcontrib>Sulaiman, Nor Shazrina</creatorcontrib><creatorcontrib>Marudai, Mitsuru</creatorcontrib><creatorcontrib>Kajihara, Akifumi</creatorcontrib><creatorcontrib>Miyazaki, Shuichiro</creatorcontrib><creatorcontrib>Sekii, Shuhei</creatorcontrib><creatorcontrib>Uezono, Haruka</creatorcontrib><creatorcontrib>Ota, Yousuke</creatorcontrib><creatorcontrib>Soejima, Toshinori</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of radiation research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Inoue, Yuko</au><au>Tsujino, Kayoko</au><au>Sulaiman, Nor Shazrina</au><au>Marudai, Mitsuru</au><au>Kajihara, Akifumi</au><au>Miyazaki, Shuichiro</au><au>Sekii, Shuhei</au><au>Uezono, Haruka</au><au>Ota, Yousuke</au><au>Soejima, Toshinori</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Re-evaluation of prophylactic cranial irradiation in limited-stage small cell lung cancer: a propensity score matched analysis</atitle><jtitle>Journal of radiation research</jtitle><addtitle>J Radiat Res</addtitle><date>2021-09-01</date><risdate>2021</risdate><volume>62</volume><issue>5</issue><spage>877</spage><epage>883</epage><pages>877-883</pages><issn>0449-3060</issn><eissn>1349-9157</eissn><abstract>Abstract We attempted to re-evaluate the efficacy of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC) with more recent data. A total of 179 patients with LS-SCLC received radical thoracic radiotherapy and chemotherapy at our institution between 1998 and 2018. One hundred twenty-eight patients who achieved complete response (CR), good partial response (PR), and PR without progression for at least for one year after initial therapy were enrolled in this study. These patients were divided into a PCI group (group A, n = 43), and a non-PCI group (group B, n = 85). Survival outcomes were retrospectively evaluated. Because several background factors differed significantly between groups A and B, propensity score (PS) matching was performed as 1:1 match of the two groups. Finally, we analyzed 64 patients (group A/B = 32/32). Median follow-up periods were 53 and 31 months in groups A and B, respectively. There were no significant differences between the groups’ backgrounds. Two-year overall survival (OS) rates were 77% in group A and 62% in group B (p = 0.224). 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subjects Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Brain Neoplasms - prevention & control
Brain Neoplasms - secondary
Cancer
Care and treatment
Chemotherapy
Combined Modality Therapy
Cranial Irradiation - methods
Development and progression
Disease Progression
Female
Follow-Up Studies
Humans
Kaplan-Meier Estimate
Lung cancer, Small cell
Lung Neoplasms - drug therapy
Lung Neoplasms - pathology
Lung Neoplasms - radiotherapy
Male
Medical research
Medicine, Experimental
Metastasis
Middle Aged
Neoplasm Staging
Oncology/Medicine
Progression-Free Survival
Propensity Score
Radiotherapy
Small Cell Lung Carcinoma - pathology
Small Cell Lung Carcinoma - prevention & control
Small Cell Lung Carcinoma - secondary
Small Cell Lung Carcinoma - therapy
Treatment Outcome
title Re-evaluation of prophylactic cranial irradiation in limited-stage small cell lung cancer: a propensity score matched analysis
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