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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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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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.</description><identifier>ISSN: 0449-3060</identifier><identifier>EISSN: 1349-9157</identifier><identifier>DOI: 10.1093/jrr/rrab053</identifier><identifier>PMID: 34230962</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>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</subject><ispartof>Journal of radiation research, 2021-09, Vol.62 (5), p.877-883</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology. 2021</rights><rights>The Author(s) 2021. Published by Oxford University Press on behalf of The Japanese Radiation Research Society and Japanese Society for Radiation Oncology.</rights><rights>COPYRIGHT 2021 Oxford University Press</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c503t-800aaeb6751802d7ec712d1196da3a26c71112678336adde46184f033d7d76453</citedby><cites>FETCH-LOGICAL-c503t-800aaeb6751802d7ec712d1196da3a26c71112678336adde46184f033d7d76453</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438250/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8438250/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,1598,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34230962$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><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><title>Re-evaluation of prophylactic cranial irradiation in limited-stage small cell lung cancer: a propensity score matched analysis</title><title>Journal of radiation research</title><addtitle>J Radiat Res</addtitle><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.</description><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Brain Neoplasms - prevention & control</subject><subject>Brain Neoplasms - secondary</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Combined Modality Therapy</subject><subject>Cranial Irradiation - methods</subject><subject>Development and progression</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Lung cancer, Small cell</subject><subject>Lung Neoplasms - drug therapy</subject><subject>Lung Neoplasms - pathology</subject><subject>Lung Neoplasms - radiotherapy</subject><subject>Male</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Neoplasm Staging</subject><subject>Oncology/Medicine</subject><subject>Progression-Free Survival</subject><subject>Propensity Score</subject><subject>Radiotherapy</subject><subject>Small Cell Lung Carcinoma - pathology</subject><subject>Small Cell Lung Carcinoma - prevention & control</subject><subject>Small Cell Lung Carcinoma - secondary</subject><subject>Small Cell Lung Carcinoma - therapy</subject><subject>Treatment Outcome</subject><issn>0449-3060</issn><issn>1349-9157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><sourceid>EIF</sourceid><recordid>eNp9kk2LFDEQhoMo7jh68i4BQQTp3Xx0p7s9CMviFywIoudQk1TPZEknY9K9MBd_uxl7XFwQCSSV5Kk3b5Ei5Dln55z18uImpYuUYMMa-YCsuKz7qudN-5CsWF1iyRQ7I09yvmFMtKxhj8mZrIVkvRIr8vMrVngLfobJxUDjQPcp7ncHD2ZyhpoEwYGnrjxg3cK4QL0b3YS2yhNskeYRvKcGy-TnsKUGgsH0lsJvLQzZTQeaTUxIR5jMDi2FAP6QXX5KHg3gMz47rWvy_cP7b1efqusvHz9fXV5XpmFyqjrGAHCj2oZ3TNgWTcuF5bxXFiQIVbacC9V2UiqwFmvFu3pgUtrWtqpu5Jq8W3T382ZEazBMCbzeJzdCOugITt-_CW6nt_FWd7XsRPGwJq9PAin-mDFPenT5WDIEjHPWoql7wYo5VdCXC7oFj9qFIRZFc8T1Zav6YlR2R8Hzf1BlWBydiQEHV87vJbxZEkyKOScc7txzpo-NoEsj6FMjFPrF3wXfsX9-vgCvFiDO-_8q_QISL74h</recordid><startdate>20210901</startdate><enddate>20210901</enddate><creator>Inoue, Yuko</creator><creator>Tsujino, Kayoko</creator><creator>Sulaiman, Nor Shazrina</creator><creator>Marudai, Mitsuru</creator><creator>Kajihara, Akifumi</creator><creator>Miyazaki, Shuichiro</creator><creator>Sekii, Shuhei</creator><creator>Uezono, Haruka</creator><creator>Ota, Yousuke</creator><creator>Soejima, Toshinori</creator><general>Oxford University Press</general><scope>TOX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20210901</creationdate><title>Re-evaluation of prophylactic cranial irradiation in limited-stage small cell lung cancer: a propensity score matched analysis</title><author>Inoue, Yuko ; Tsujino, Kayoko ; Sulaiman, Nor Shazrina ; Marudai, Mitsuru ; Kajihara, Akifumi ; Miyazaki, Shuichiro ; Sekii, Shuhei ; Uezono, Haruka ; Ota, Yousuke ; Soejima, Toshinori</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c503t-800aaeb6751802d7ec712d1196da3a26c71112678336adde46184f033d7d76453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Brain Neoplasms - prevention & control</topic><topic>Brain Neoplasms - secondary</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Chemotherapy</topic><topic>Combined Modality Therapy</topic><topic>Cranial Irradiation - methods</topic><topic>Development and progression</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Lung cancer, Small cell</topic><topic>Lung Neoplasms - drug therapy</topic><topic>Lung Neoplasms - pathology</topic><topic>Lung Neoplasms - radiotherapy</topic><topic>Male</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Neoplasm Staging</topic><topic>Oncology/Medicine</topic><topic>Progression-Free Survival</topic><topic>Propensity Score</topic><topic>Radiotherapy</topic><topic>Small Cell Lung Carcinoma - pathology</topic><topic>Small Cell Lung Carcinoma - prevention & 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). 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.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>34230962</pmid><doi>10.1093/jrr/rrab053</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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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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