Table 6.
Summary of the main studies of prophylactic cranial irradiation in small cell lung cancer
|
PCI in SCLC
|
|
|||||||
|
Ref.
|
Stage (LS or ES)
|
Phase
|
Treatment
|
Survival
|
P
value
|
Incidence of BM
|
P
value
|
Level of evidence
|
| Arriagada et al[144] 2002 | LS | III | PCI; no PCI | 18% at 5 yr; 15% at 5 yr | 0.06 | 20% at 5 yr; 37% at 5 yr | < 0.001 | A I |
| Aupérin et al[33] 1999 | LS | Meta-analysis | PCI; no PCI | 20.7%; 15.3% | 0.01 | 0.38; 0.57 | 0.001 | A I |
| Warde et al[20] 1992 | LS | Meta-analysis | PCI; no PCI | HR 0.82 | HR 0.48 | A I | ||
| Takahashi et al[122] 2017 | ES | III | PCI; MRI + no PCI | 13.6 mo; 11.6 mo | 48%; 69% | A I | ||
| Rusthoven et al[81] 2020 | III | WBRT; SRS | 5.2 mo; 6.5 mo | 0.003 | A I | |||
| Yin et al[145] 2019 | Meta-analysis | PCI; observation | HR 0.81 | < 0.001 | HR 0.45 | < 0.001 | A II | |
| De Ruysscher et al[146] 2018 | III | PCI; observation | 24.2 mo; 21.9 mo | 0.56 | 7%; 27.2% | 0.001 | A I | |
| Slotman et al[38] 2007 | ES | III | PCI; no PCI | 6.7 mo; 5.4 mo | 15% at 1 yr; 40% at 1 yr | < 0.001 | A I | |
| Le Péchoux et al[154] 2009 | LS | III | Standard dose PCI; high dose PCI | 42%; 37% | 0.05 | 29% at 2 yr; 23% at 2 yr | 0.18 | A I |
| Ref. | Stage (LS or ES) | Phase | Treatment | Median Survival | P value | Incidence of neurological deficit | P value | Level of evidence |
| Yang et al[157] 2018 | LS | Meta-analysis | PCI; no PCI | HR 0.52 | RR 0.5 | A I | ||
| Viani et al[148] 2012 | LS-ES | Meta-analysis | PCI; no PCI | OR 0.73 | 0.01 | |||
| Ge et al[149] 2018 | ES | Meta-analysis | PCI; no PCI | HR 0.57 | < 0.001 | RR 0.47 | < 0.01 | A I |
| Brown et al[164] 2020 | III | HA + WBRT + Memantine; WBRT + Memantine | Learning 11.5%, memory 16.4%; learning 24.7%, memory 33.3% | 0.049; 0.02 | AI | |||
| van Meerbeeck et al[165] 2019 | III | PCI; PCI + HA | HVLT-R 28%; 29% | > 0.05 | A I | |||
| De Dios et al[167] 2019 | LS-ES | III | PCI; PCI + HA | FCSRT 21.7%, 32.6%, and 18.5% at 3, 6 and 12 mo; FCSRT 5.1%, 7.3% and 3.8% at 3, 6 and 12 mo | < 0.05 | AI | ||
LS: Limited-stage; ES: Extensive-stage; PCI: Prophylactic cranial irradiation; SCLC: Small cell lung cancer; WBRT: Whole brain radiotherapy; SRS: Stereotactic radiosurgery; HR: Hazard ratio; RR: Relative risk; OR: Odds ratio; MRI: Magnetic resonance imaging; HA: Hippocampal avoidance; BM: Brain metastasis; HVLT-R: Hopkins Revised Verbal Learning Test; FCSRT: Free and cued selective reminding test.