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Titolo:
Practice guideline on prophylactic cranial irradiation in small-cell lung cancer
Autore:
Kotalik, J; Yu, E; Markman, BR; Evans, WK;
Indirizzi:
Canc Care Ontario, Lung Canc Dis Site Grp, Toronto, ON M5G 2L7, Canada Canc Care Ontario Toronto ON Canada M5G 2L7 , Toronto, ON M5G 2L7, Canada Lakehead Univ, Thunder Bay, ON P7B 5E1, Canada Lakehead Univ Thunder Bay ON Canada P7B 5E1 under Bay, ON P7B 5E1, Canada London Reg Canc Ctr, London, ON N6A 4L6, Canada London Reg Canc Ctr London ON Canada N6A 4L6 , London, ON N6A 4L6, Canada McMaster Univ, Program Evidence Based Care, Hamilton, ON, Canada McMaster Univ Hamilton ON Canada idence Based Care, Hamilton, ON, Canada
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 2, volume: 50, anno: 2001,
pagine: 309 - 316
SICI:
0360-3016(20010601)50:2<309:PGOPCI>2.0.ZU;2-Z
Fonte:
ISI
Lingua:
ENG
Soggetto:
COMPLETE REMISSION; COMPLETE RESPONSE; CARCINOMA; TRIAL;
Keywords:
small-cell lung cancer; cranial irradiation; practice guideline; treatment guideline;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
14
Recensione:
Indirizzi per estratti:
Indirizzo: Evans, WK Canc Care Ontario, Lung Canc Dis Site Grp, 620 Univ Ave, Toronto, ON M5G 2L7, Canada Canc Care Ontario 620 Univ Ave Toronto ON Canada M5G 2L7 Canada
Citazione:
J. Kotalik et al., "Practice guideline on prophylactic cranial irradiation in small-cell lung cancer", INT J RAD O, 50(2), 2001, pp. 309-316

Abstract

Purpose: To develop an evidence-based clinical practice guideline that would address the following questions: (a) What is the role of prophylactic cranial irradiation (PCI) in patients with limited or extensive stage small-cell lung cancer (SCLC) who have achieved complete remission in response to induction therapy (chemotherapy or chemoradiotherapy)? (b) What dose and fractionation schedules of PCI are optimal? (c) Does the use of PCI in patients with SCLC in complete remission affect quality of life? Survival, disease-free survival, quality of life, and adverse effects were the outcomes of interest. Methods and Materials: A systematic review of the published literature wasundertaken to provide the data for an evidence based practice guideline. Results: Six randomized controlled trials and one fully published individual patient data meta-analysis were included in the systematic review of theevidence. For patients who have achieved complete response after inductiontherapy, there is evidence of a disease-free survival benefit (4 of 6 trials) and an overall survival benefit (meta-analysis), There is insufficient evidence to make a definitive recommendation with respect to dose. There issome indication that 30-36 Gy in 2-3 Gy per fraction, or a biologically equivalent dose, may produce a better outcome than a lower dose or less aggressive fractionation regimen. The schedule commonly used in Canada is 25 Gy in 10 fractions over 2 weeks. Data from further research, including a trialcurrently ongoing that compares 25 Gy in 10 fractions with 36 Gy in 18 fractions, will be required to determine optimal dose of PCI, There is insufficient evidence to make recommendations concerning the optimal timing of PCIin relation to the administration of chemotherapy, Lung DSG members generally felt that it should be given as soon as possible after completion of chemotherapy. There is evidence from trials with data for up to 2 years of follow-up that prophylactic cranial irradiation does not produce significant late neurotoxicity, There is evidence from one trial that prophylactic cranial irradiation does not have a detrimental effect on quality of life in the first 12 months following the completion of therapy. There is insufficient evidence to comment on the long-term effects of prophylactic cranial irradiation on quality of life. Conclusion: For adult patients with limited or extensive SCLC who achieve a complete remission with induction therapy, PCI is recommended. (C) 2001 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 12:12:04