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. 2005 Apr 18;2005(2):CD005221.
doi: 10.1002/14651858.CD005221.

Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small cell lung cancer

J F Lester  1 , B Coles, F R Macbeth
Affiliations

Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non-small cell lung cancer

J F Lester et al. Cochrane Database Syst Rev. .

Abstract

Background: In non-small cell lung cancer (NSCLC), there is a relatively high incidence of brain metastases following radical treatment. At present, the role of prophylactic cranial irradiation (PCI) in this group of patients is not clear.

Objectives: To investigate whether PCI has a role in the management of patients with NSCLC treated with radical intent.

Search strategy: The electronic databases MEDLINE, EMBASE and Cancerlit, along with handsearching of journals, relevant books, and review articles used to identify potentially eligible trials.

Selection criteria: Randomised controlled trials (RCTs) comparing PCI with no PCI in NSCLC patients treated with radical intent.

Data collection and analysis: Four RCTs were reviewed. Due to the small patient numbers, and variations in radiotherapy (RT) dose, no meta-analysis was attempted.

Main results: PCI may reduce the incidence of brain metastases, but there is no evidence of a survival benefit. There is no evidence that any regimen is superior, and the effect of PCI on quality of life (QOL) is not known.

Authors' conclusions: There is insufficient evidence to support the use of PCI in clinical practice. Where possible, patients should be offered entry into a clinical trial.

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Conflict of interest statement

None known

References

References to studies included in this review

RTOG 84‐03 {published data only}
    1. Russell AH, Pajak TE, Selim HM, Paradelo JC, Murray K, Bansal P, et al. Prophylactic Cranial Irradiation For Lung Cancer Patients At High Risk For Development Of Cerebral Metastasis: Results Of A Prospective Randomised Trial Conduced By The Radiation Therapy Oncology Group. International Journal of Radiation Oncology Biology and Physics 1991;21:637‐43. - PubMed
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References to studies excluded from this review

Pottgen 2007 {published data only}
    1. Pottgen C, W. Eberhardt. Prophylactic Cranial Irradiation in Operable Stage IIIA Non‐small cell Lung Cancer treated with Neo‐adjuvant chemoradiotherapy:Results from a German Mulitcenter Randomised trial. Journal of Clinical Oncology 2007;25(31):4987‐4992. - PubMed

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RTOG 0214 {published data only}
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References to other published versions of this review

Lester 2005
    1. Lester JF, Coles B, MacBeth F. Prophylactic cranial irradiation for preventing brain metastases in patients undergoing radical treatment for non‐small cell lung cancer. Cochrane Database of Systematic Reviews 2005, Issue 2. [DOI: 10.1002/14651858.CD005221] - DOI - PMC - PubMed

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