Radiotherapy for brain metastases from small-cell lung cancer in distinct clinical indications and scenarios
Autor: | Lucyna Kepka, Beata Sas-Korczyńska, Joanna Socha |
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Rok vydání: | 2021 |
Předmět: |
Pulmonary and Respiratory Medicine
Oncology Chemotherapy medicine.medical_specialty business.industry medicine.medical_treatment Cancer medicine.disease Radiosurgery Clinical trial Radiation therapy 03 medical and health sciences 0302 clinical medicine Review Article on Radiotherapy for Brain Metastases from Lung Cancer 030220 oncology & carcinogenesis Internal medicine Conventional PCI medicine 030212 general & internal medicine Prophylactic cranial irradiation business Lung cancer |
Zdroj: | J Thorac Dis |
ISSN: | 2077-6624 2072-1439 |
Popis: | Management of brain metastases (BM) from small-cell lung cancer (SCLC) is complex and not supported by a strong evidence from prospective clinical trials. Owing to the different clinical and pathological characteristics of SCLC, patients with this histology were not included in the prospective studies on the value of whole-brain radiotherapy (WBRT) and local surgical or ablative radiation treatment like stereotactic radiosurgery (SRS). Chemotherapy also represents a major part of the armamentarium against BM from SCLC due to the well-recognized chemoresponsiveness of this cancer and the frequent presentation of BM with extracranial progression. WBRT in combination with chemotherapy has long been a standard approach in this setting. However, data on the neurocognitive toxicity and the lack of documented impact on overall survival of WBRT in the management of BM from other solid tumors, as well as the increasing availability of the stereotactic radiotherapy technologies, has led to the increasing use of SRS with omission of WBRT also in SCLC. In the current review the use of different modalities of radiotherapy and ways of combining radiotherapy with chemotherapy for BM from SCLC will be presented for distinct clinical situations: presentation of BM synchronous with primary, metachronous presentation of BM—without previous prophylactic cranial irradiation (PCI) vs. after PCI, and asymptomatic BM found at the staging before PCI. |
Databáze: | OpenAIRE |
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