TY - JOUR
T1 - 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)
AU - Le Péchoux, C.
AU - Laplanche, A.
AU - Faivre-Finn, C.
AU - Ciuleanu, T.
AU - Wanders, R.
AU - Lerouge, D.
AU - Keus, R.
AU - Hatton, M.
AU - Videtic, G. M.
AU - Senan, S.
AU - Wolfson, A.
AU - Jones, R.
AU - Arriagada, R.
AU - Quoix, E.
AU - Dunant, A.
N1 - Funding Information:
Funded by unrestricted grants from Institut Gustave-Roussy; Association pour la Recherche sur le Cancer (2001); Programme Hospitalier de Recherche Clinique (2007). The EORTC contribution to this trial was supported by National Cancer Institute (Bethesda, MD) (5U10 CA11488-30 through 5U10 CA011488-38).
PY - 2011/5
Y1 - 2011/5
N2 - Background: 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). Patients and methods: 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. Results: 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). Conclusion: 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.
AB - Background: 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). Patients and methods: 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. Results: 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). Conclusion: 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.
KW - Limited disease
KW - Neurocognitive evaluation
KW - Phase III clinical trial
KW - Prophylactic cranial irradiation
KW - Quality of life
KW - Small-cell lung cancer
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U2 - 10.1093/annonc/mdq576
DO - 10.1093/annonc/mdq576
M3 - Article
C2 - 21139020
AN - SCOPUS:79955494691
VL - 22
SP - 1154
EP - 1163
JO - Annals of Oncology
JF - Annals of Oncology
SN - 0923-7534
IS - 5
ER -