ArticleClinical and translational radiation oncology2021
Limited-stage small cell lung cancer: Outcomes associated with prophylactic cranial irradiation over a 20-year period at the Princess Margaret Cancer Centre.
Article in Clinical and translational radiation oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prophylactic Cranial Irradiation Versus Active MRI Surveillance in Small Cell Lung Cancer: Systematic Review and Meta-Analysis.Journal of medical imaging and radiation oncology · 2026Pooled it
- Prophylactic Cranial Irradiation and Survival in Limited-Stage SCLC: A Multicenter Real-World Analysis From the Canadian SCLC Database (CASCADE).JTO clinical and research reports · 2026Article
- Advances in Immunotherapy and Chemoradiotherapy Combination for Limited-Stage Small-Cell Lung Cancer: Current Landscape and Future Frontiers.Current oncology reports · 2025Review
- The impact of Prophylactic cranial irradiation on the prognosis of patients with limited-stage small cell lung cancer in the MRI era.Radiation oncology (London, England) · 2024Article
- Prophylactic cranial irradiation-related lymphopenia affects survival in patients with limited-stage small cell lung cancer.Heliyon · 2023Article
- Real-world predictors of survival in patients with limited-stage small-cell lung cancer in Manitoba, Canada.Frontiers in oncology · 2023Article
- Prophylactic cranial irradiation (PCI) versus active surveillance in patients with limited-stage small cell lung cancer: a retrospective, multicentre study.Respiratory research · 2022Article
- The overall survival impact of prophylactic cranial irradiation in limited-stage small-cell lung cancer: A systematic review and meta-analysis.Clinical and translational radiation oncology · 2022Review
- One Cycle of Concurrent Chemotherapy vs. Two Cycles of Concurrent Chemotherapy With Radiation Therapy in Patients With Limited-Stage Small Cell Lung Cancer.Frontiers in oncology · 2021Article
Corrections and comments
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Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND & PURPOSE: Prophylactic cranial irradiation (PCI) is recommended for limited-stage small-cell lung cancer (LS-SCLC) patients with good response to concurrent chemoradiation. We report our institution's 20-year experience with this patient population and associated clinical outcomes. MATERIALS &
methodsA retrospective cohort of consecutive LS-SCLC patients treated with curative intent chemoradiation at our institution (1997-2018) was reviewed. Overall survival (OS) was calculated using the Kaplan-Meier method, and significant covariates determined by the Cox proportional hazards model. Covariates predictive of PCI were determined using Fisher's exact test and the Mann-Whitney test. Brain failure risk (BFR) was calculated using the cumulative incidence method treating death as a competing event. Treatment cohorts (historic vs. contemporary) were stratified by the median year of diagnosis (2005).
resultsA total of 369 patients with LS-SCLC were identified, of which 278 patients were notionally PCI eligible. PCI was given to 196 patients (71%). Younger age was associated with PCI utilization (p < 0.001). PCI utilization rates did not change between the historic and contemporary treatment era (p = 0.11), whereas magnetic resonance imaging (MRI) use at baseline and follow-up became more prevalent in the contemporary era (p = <0.001). On multivariable analysis, PCI utilization was associated with improved OS (HR 1.88, 95% CI 1.32-2.69) and decreased BFR (HR 4.66, 95% CI 2.58-8.40). Patients who had MRI follow-up had a higher incidence of BFR (HR 0.35, 95% CI 0.18-0.66) in multivariable analyses.
conclusionsFor LS-SCLC patients at our institution, PCI is more frequently utilized in younger patients, and the utilization rate did not change significantly over the past 20 years. PCI was independently associated with improved OS and lower BFR. Omission of PCI in LS-SCLC patients should not be routinely practiced in the absence of further prospective data.
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