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Titolo:
NEUROLOGIC DISORDERS IN 203 CONSECUTIVE PATIENTS WITH SMALL-CELL LUNG-CANCER - RESULTS OF A LONGITUDINAL-STUDY
Autore:
VANOOSTERHOUT AGM; VANDEPOL M; TENVELDE GPM; TWIJNSTRA A;
Indirizzi:
UNIV LIMBURG HOSP,DEPT NEUROL,POB 5800 6202 AZ MAASTRICHT NETHERLANDS UNIV LIMBURG HOSP,DEPT NEUROL 6202 AZ MAASTRICHT NETHERLANDS UNIV LIMBURG HOSP,DEPT PULM 6202 AZ MAASTRICHT NETHERLANDS
Titolo Testata:
Cancer
fascicolo: 8, volume: 77, anno: 1996,
pagine: 1434 - 1441
SICI:
0008-543X(1996)77:8<1434:NDI2CP>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROPHYLACTIC CRANIAL IRRADIATION; COMBINATION CHEMOTHERAPY; BRONCHOGENIC CARCINOMA; BRAIN IRRADIATION; CNS METASTASES; FOLLOW-UP; SURVIVAL; FREQUENCY; STAGE; ABNORMALITIES;
Keywords:
LUNG NEOPLASM; SMALL CELL LUNG CANCER; NEUROLOGIC COMPLICATIONS; BRAIN METASTASIS; PARANEOPLASTIC SYNDROME; NEUROPATHY; MYOPATHY; ENCEPHALOPATHY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
41
Recensione:
Indirizzi per estratti:
Citazione:
A.G.M. Vanoosterhout et al., "NEUROLOGIC DISORDERS IN 203 CONSECUTIVE PATIENTS WITH SMALL-CELL LUNG-CANCER - RESULTS OF A LONGITUDINAL-STUDY", Cancer, 77(8), 1996, pp. 1434-1441

Abstract

BACKGROUND, Neurologic complications of small cell lung cancer (SCLC)are manifold. The incidence and course of the various metastatic and nonmetastatic neurologic disorders were studied prospectively in a cohort of SCLC patients. METHODS, The 203 patients underwent neurologic examinations on a regular basis, prior to therapy, during, and after treatment, from 1983 through 1994. Routine computer tomography or magnetic resonance imaging of the brain was performed before therapy and after 2 years' survival. Other auxiliary diagnostic tests were performed as required. RESULTS, The majority of the 174 neurologic disorders, diagnosed in 132 patients, were associated with metastases. A total of 79 patients developed brain metastases. The cumulative risk of brain metastases reached 47% for limited and 69% for extensive disease patients at 2 years from diagnosis. Survival following the diagnosis of brainmetastases was significantly longer for patients with brain metastases at the initial diagnosis of SCLC than for patients with delayed brain metastases (P < 0.01, log rank test). The most frequent paraneoplastic syndrome with neurologic symptoms was that of inappropriate secretion of antidiuretic hormone (SIADH), which was diagnosed in 11 patients. Antibody-mediated paraneoplastic neurologic syndromes were diagnosedin five patients. Chemotherapy for SCLC caused SIADH to subside in most patients. In contrast, the antibody-mediated syndromes did not respond to SCLC therapy. Adverse effects of treatment included peripheral neuropathy, encephalopathy, radiation plexopathy, and steroid myopathy. However, unlike the other complications, peripheral neuropathy was reversible. CONCLUSIONS, This clinical investigation confirmed the frequency of central nervous system metastatic involvement as well as the diversity of the neurologic complications in SCLC. The high frequency of brain metastases justifies a reappraisal of prophylactic cranial irradiation in this patient group. (C) 1996 American Cancer Society.

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Documento generato il 01/12/20 alle ore 01:08:52