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Current approaches for prophylactic cranial irradiation in extrapulmonary small cell carcinoma
Ozan Yazıcı1, Nuriye Y Ozdemir, Mehmet A N Sendur
1Ankara Numune Education and Research Hospital , Ankara , Turkey.
Current Medical Research and Opinion
|March 18, 2014
Summary
Prophylactic cranial irradiation (PCI) is not routinely recommended for extrapulmonary small cell carcinoma (EPSCC). However, PCI may benefit selected patients with prostate or head and neck small cell carcinoma due to higher brain metastasis rates.
Area of Science:
- Oncology
- Radiation Oncology
Background:
- Small cell lung cancer (SCLC) management includes prophylactic cranial irradiation (PCI) for responsive patients.
- PCI is not standard for extrapulmonary small cell carcinoma (EPSCC).
Purpose of the Study:
- To review all aspects of prophylactic cranial irradiation (PCI) in the management of extrapulmonary small cell carcinoma (EPSCC).
Main Methods:
- Searched PubMed, ASCO, and GU Cancers databases up to October 2013.
- Keywords included 'SCC or EPSCC' and 'prophylactic cranial radiotherapy'.
- Selected English-language papers with largest case series and recent data on PCI.
Main Results:
- Low brain metastasis incidence in esophageal, genitourinary, colorectal, small bowel, and appendix SCC; PCI not recommended.
- Prostate SCC shows higher brain metastasis rates (16-19%); PCI considered for selected cases.
- Head and neck SCC has high brain metastasis rates (41%); PCI should be considered.
Conclusions:
- Brain metastasis incidence in EPSCC varies widely (1.7%-40%).
- PCI is generally not recommended for most EPSCC.
- PCI is recommended for primary head and neck and prostate SCC on an individual basis due to high cranial metastasis rates.
