RETROSPECTIVE STUDY OF PROPHYLACTIC CRANIAL IRRADIATION IN SMALL-CELL LUNG CANCER: NEUROCOGNITIVE ANALYSIS

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Abstract

Background

PCI has been established as the standard therapy for SCLC. The concerns of severe late neurotoxicity and detrimental impact on the QOL of patients undergoing PCI have been reported but never seriously studied. We therefore studied the neurocognitive functioning (NCF) of small-cell lung cancer cases treated with PCI in our institution.

Patients and methods

We retrospectively analyzed small-cell lung cancer cases treated with PCI atour hospital between 2004 and 2011. NCF was assessed using the Mini-Mental Status Examination (MMSE). The median follow-up time for all patients was 25 months (range, 4–85 months).

Results

Seventeen small-cell lung cancer cases treated with PCI were identified. Their median age was 66 years (range, 52–78 years). Brain metastases after PCI occurred in six patients (35%). Dementia occurred in five patients (29%, 3–40 months after PCI) without or before appearance of brain metastases. The median age of patients with dementia was 75 years (range, 68–78 years). Gait disturbance appeared in three patients (18%, 9–27 months after PCI).

Conclusion

The impact of PCI on NCF needs to be considered, especially in older patients. We should consider the risk and the beneficial effects of PCI on survival and incidence of brain metastases.

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