Prophylactic cranial irradiation in small cell carcinoma of the lung. A randomized study
D. V. Jackson Jr, F. Richards 2nd, M. R. Cooper, C. Ferree, H. B. Muss, D. R. White and C. L. Spurr
Twenty-nine patients with small cell carcinoma of the lung and without
evidence of brain metastasis were randomized into two treatment groups
consisting of 14 patients who received prophylactic cranial irradiation
(PCI) and 15 who received none (non-PCI). All patients were treated with
irradiation of the primary lesion and concomitant chemotherapy. The
response rate and median survival of the two groups were not significantly
different: 93% and 7.2 months in the non-PCI; 86% and 9.8 months in the
PCI; P larger than or equal to .05. Brain metastasis occurred in 0/14
patients in the PCI and 4/15 in the non-PCI (P less than or equal to .05)
and was the cause of major neurologic disability in each. Although PCI did
not improve response rate or survival, brain metastasis with its attendant
neurologic complications was effectively prevented.
