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BRIEF REPORT Should Patients with Extrapulmonary Small-Cell Carcinoma Receive Prophylactic Cranial Irradiation? Jarushka Naidoo, MB BcH BAO, MRCPI,* Min Yuen Teo, MB BcH BAO,† Sandra Deady, MB BcH BAO,‡ Harry Comber, MB BcH BAO,‡ Paula Calvert, MB Bch BAO, MRCPI* mall-cell carcinomas (SCLCs) are a subset of neuroen- Introduction: Extrapulmonary small-cell carcinoma (EPSCC) is a Sdocrine tumors with poor differentiation, elevated mitotic rare disease. Management is based on small-cell lung carcinoma. rate, and a high proliferation index. These cancers are bio- Prophylactic cranial irradiation (PCI) is not routinely administered logically aggressive, disseminate early, and have a poor over- in EPSCC. This study investigates the role of PCI in EPSCC, by ana- all prognosis. SCLCs most commonly originate in the lung. lyzing the incidence, treatment, and survival of patients with brain Between 10 and 14% of patients with SCLC present with brain metastases in a national cohort. Disease biology and epidemiology metastases at diagnosis, and 80% will develop brain metasta- are also investigated. ses within 2 years of diagnosis. Prophylactic cranial irradia- Methods: Patients diagnosed with primary EPSCC from the tion (PCI) reduces the morbidity and mortality associated with National Cancer Registry of Ireland from 1995 to 2007 were identi- brain metastases in SCLC. Phase III studies demonstrate
Journal of Thoracic Oncology – Wolters Kluwer Health
Published: Sep 1, 2013
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