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Prophylactic cranial irradiation in small cell lung cancer: a systematic review and meta-analysis.


ABSTRACT:

Background

The efficacy of prophylactic cranial irradiation (PCI) in treating patients with small cell lung cancer (SCLC) has not been clear, and recent randomized studies have demonstrated conflicting results from previously published findings. The purpose of this study was to reevaluate the efficacy of PCI in patients with SCLC and to assess factors associated with its efficacy.

Methods

We conducted a quantitative meta-analysis to explore the efficacy of PCI in patients with SCLC. A literature search was performed using EMBASE, MEDLINE, Cochrane and ClinicalTrials.gov databases. We pooled the data and compared overall survival (OS) and brain metastasis (BM) between patients treated with PCI (PCI group) and patients without PCI treatment (observation group).

Results

Of the 1074 studies identified in our analysis, we selected seven studies including 2114 patients for the current meta-analysis. Our results showed that the PCI group showed decreased BM (HR?=?0.45, 95% CI: 0.38-0.55, P?2 =?74.1%, P?=?0.001). In subgroup analyses of OS, we found that the heterogeneity mainly came from patients with brain imaging after initial chemoradiotherapy (HR?=?0.94, 95% CI: 0.74-1.18, P?=?0.59).

Conclusions

The results of this study showed that PCI has a significant effect on decreasing BM but little benefit in prolonging OS when brain imaging was introduced to confirm lack of BM after initial chemoradiotherapy and before irradiation.

SUBMITTER: Yin X 

PROVIDER: S-EPMC6341615 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Prophylactic cranial irradiation in small cell lung cancer: a systematic review and meta-analysis.

Yin Xin X   Yan Danfang D   Qiu Miao M   Huang Liming L   Yan Sen-Xiang SX  

BMC cancer 20190121 1


<h4>Background</h4>The efficacy of prophylactic cranial irradiation (PCI) in treating patients with small cell lung cancer (SCLC) has not been clear, and recent randomized studies have demonstrated conflicting results from previously published findings. The purpose of this study was to reevaluate the efficacy of PCI in patients with SCLC and to assess factors associated with its efficacy.<h4>Methods</h4>We conducted a quantitative meta-analysis to explore the efficacy of PCI in patients with SCL  ...[more]

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