Clinical neurological outcome and quality of life among patients with limited small-cell cancer treated with two different doses of prophylactic cranial irradiation in the intergroup phase III trial (PCI99-01, EORTC 22003-08004, RTOG 0212 and IFCT 99-01)
- 1 May 2011
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 22 (5), 1154-1163
- https://doi.org/10.1093/annonc/mdq576
Abstract
We recently published the results of the PCI99 randomised trial comparing the effect of a prophylactic cranial irradiation (PCI) at 25 or 36 Gy on the incidence of brain metastases (BM) in 720 patients with limited small-cell lung cancer (SCLC). As concerns about neurotoxicity were a major issue surrounding PCI, we report here midterm and long-term repeated evaluation of neurocognitive functions and quality of life (QoL). At predetermined intervals, the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 and brain module were used for self-reported patient data, whereas the EORTC-Radiation Therapy Oncology Group Late Effects Normal Tissue-Subjective, Objective, Management, Analytic scale was used for clinicians' assessment. For each scale, the unfavourable status was analysed with a logistic model including age, grade at baseline, time and PCI dose. Over the 3 years studied, there was no significant difference between the two groups in any of the 17 selected items assessing QoL and neurological and cognitive functions. We observed in both groups a mild deterioration across time of communication deficit, weakness of legs, intellectual deficit and memory (all P < 0.005). Patients should be informed of these potential adverse effects, as well as the benefit of PCI on survival and BM. PCI with a total dose of 25 Gy remains the standard of care in limited-stage SCLC.Funding Information
- Institut Gustave-Roussy
- Association pour la Recherche sur le Cancer
- Programme Hospitalier de Recherche Clinique
- National Cancer Institute (5U10 CA11488-30, 5U10 CA011488-38)
This publication has 36 references indexed in Scilit:
- Primary Analysis of a Phase II Randomized Trial Radiation Therapy Oncology Group (RTOG) 0212: Impact of Different Total Doses and Schedules of Prophylactic Cranial Irradiation on Chronic Neurotoxicity and Quality of Life for Patients With Limited-Disease Small-Cell Lung CancerInternational Journal of Radiation Oncology*Biology*Physics, 2011
- Standard-dose versus higher-dose prophylactic cranial irradiation (PCI) in patients with limited-stage small-cell lung cancer in complete remission after chemotherapy and thoracic radiotherapy (PCI 99-01, EORTC 22003-08004, RTOG 0212, and IFCT 99-01): a randomised clinical trialThe Lancet Oncology, 2009
- Prophylactic Cranial Irradiation in Extensive Disease Small-Cell Lung Cancer: Short-Term Health-Related Quality of Life and Patient Reported Symptoms—Results of an International Phase III Randomized Controlled Trial by the EORTC Radiation Oncology and Lung Cancer GroupsJournal of Clinical Oncology, 2009
- Decision Analysis for Prophylactic Cranial Irradiation for Patients With Small-Cell Lung CancerJournal of Clinical Oncology, 2006
- Whole-Brain Radiotherapy in the Management of Brain MetastasisJournal of Clinical Oncology, 2006
- Global prevalence of dementia: a Delphi consensus studyThe Lancet, 2006
- Neurocognitive Function and Progression in Patients With Brain Metastases Treated With Whole-Brain Radiation and Motexafin Gadolinium: Results of a Randomized Phase III TrialJournal of Clinical Oncology, 2004
- Survey of the administration of quality of life (QL) questionnaires in three multicentre randomised trials in cancerEuropean Journal of Cancer, 1998
- Prophylactic cranial irradiation is indicated following complete response to induction therapy in small cell lung cancer: Results of a multicentre randomised trialEuropean Journal of Cancer, 1997
- The European Organization for Research and Treatment of Cancer QLQ-C30: A Quality-of-Life Instrument for Use in International Clinical Trials in OncologyJNCI Journal of the National Cancer Institute, 1993