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Prophylactic cranial irradiation: 5 years on.

Stephen A Ryan1, Aoife C Lowney, Marie Murphy

  • 1Deparment of Neurology, Mercy University Hospital, Cork, Ireland.

BMJ Supportive & Palliative Care
|March 20, 2014
PubMed
Summary

Cancer survivors may experience long-term neurocognitive disturbance from prophylactic cranial irradiation (PCI). This case study explores risks and management strategies for this treatment-related toxicity in cancer survivorship.

Keywords:
Neurocognitive impairmentProphylactic Cranial IrradiationSmall Cell Lung < CancerSurvivorshipToxic Leucencephalopathy

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Area of Science:

  • Oncology
  • Neuroscience
  • Palliative Care

Background:

  • Cancer survivorship is increasing due to advances in treatment.
  • Long-term sequelae of cancer and its treatment present unique management challenges.
  • Interdisciplinary cancer teams must address treatment-related toxicities.

Observation:

  • A 55-year-old patient developed neurocognitive disturbance.
  • This disturbance was a consequence of prophylactic cranial irradiation (PCI).
  • The patient was diagnosed with small cell lung cancer five years prior and is now in a palliative care unit.

Findings:

  • The case highlights neurocognitive disturbance as a late effect of PCI.
  • Evidence regarding PCI and its neurocognitive risks is reviewed.
  • Potentially modifiable risk factors for PCI-induced neurocognitive disturbance are explored.

Implications:

  • This case underscores the importance of monitoring for long-term treatment toxicities in cancer survivors.
  • Understanding risk factors for neurocognitive disturbance is crucial for prevention and management.
  • Palliative care plays a role in managing complex sequelae of cancer treatment.