Prophylactic cranial irradiation for non-small cell lung cancer: a systematic review
10.3760/cma.j.issn.1004-4221.2012.05.011
- VernacularTitle:非小细胞肺癌预防性全脑照射系统评价
- Author:
Ge BAI
;
Jianqing ZHANG
;
Mei YANG
;
Yongxing BAO
;
Li ZHANG
- Publication Type:Journal Article
- Keywords:
Carcinoma,non-small cell lung;
Prophylactic cranial irradiation;
Systematic review;
Meta-analysis
- From:
Chinese Journal of Radiation Oncology
2012;21(5):432-435
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC)treated with radical intent.MethodsWe searched The Cochrane Library,MEDLINE,EMbase,CBM,CNKI and VIP.The quality of the includedstudieswascriticallyevaluated.Dataanalyseswereperformed usingtheCochrane Collaboration's RevMan 5.1 software.ResultsFour randomized controlled trials involving 905 patients met the inclusion criteria.The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group ( x2 =1.98,P =0.000 ) ; but there is no evidence of 1-year overall survival (OS) benefit ( x2 =1.12,P =0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P =0.600) or ADL ( P =0.880) after PCI,but there was a significant decline in immediate recall (P=0.030) and delayed recall (P =0.008 ) at 1 year,At 1 year,there was no significant differences in QOL after PCI ( P =0.050).Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation.There is insufficient evidence to support the use of PCI in clinical practice.Where possible,patients should be offered entry into a clinical trial.
