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PCI reduced risk for developing brain metastases, increased memory loss in NSCLC
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Patients with stage III non–small cell lung cancer decreased their risk for developing brain metastases by more than 50% when treated with prophylactic cranial irradiation compared with patients who did not receive the treatment.
Patients assigned to PCI had no significant difference in quality of life compared to those who did not undergo PCI; however, they did have a significantly increased risk for short- and long-term memory loss.
“With better, more targeted treatments, more lung cancer patients are surviving longer and are at increased risk for developing brain metastases,”
Benjamin Movsas, MD, chairman of radiation oncology at Henry Ford Hospital in Detroit, said in a press release. “This study provides key information that will lead to a better understanding of the true risks vs. benefits of this intervention.”
From September 2002 to August 2007, researchers accrued 340 patients from 127 Radiation Therapy Oncology Group institutions with stage III NSCLC whose cancer had not progressed after undergoing treatment. Patients were randomly assigned PCI or observation.
Patients assigned PCI had a lower rate of CNS metastases at one year (7.7% vs. 18%) compared with patients who did not undergo PCI (P =.004).
The researchers reported no differences between the groups for quality of life, Mini-Mental Status Exam or Activities of Daily Living Scale. However, at one year, patients in the PCI arm had a greater decline in both immediate (P=.03) and delayed memory recall (P=.008) as measured by the Hopkins Verbal Learning Test-Revised. Interestingly, there appeared to be some recovery in memory over time, as the memory effects were more prominent at three months than at six or 12 months after treatment, according to Movsas.
“The findings of this study provide a better understanding of true risks vs. benefits of prophylactic cranial irradiation and will help to more accurately assess and discuss treatment options with patients,” Movsas said during a press conference.
For more information:
- Movsas B. #2.