Kristjansen P E
Department of Oncology, Finsen Institute, Righospitalet, Copenhagen, Denmark.
Lung Cancer. 1994 Mar;10 Suppl 1:S319-29. doi: 10.1016/0169-5002(94)91696-9.
The literature on the use of prophylactic cranial irradiation (PCI) in the management of small cell lung cancer (SCLC) is reviewed, focusing on the ten randomized trials published until 1991. Eight out of ten randomized trials have shown some reduction in the frequency of CNS relapse in patients who have had PCI, whereas none have shown any survival benefit associated with PCI. Current data indicate that survival is exclusively dependent on an effect of PCI in only a very limited subgroup of patients (10% of complete responders). It is generally agreed that PCI is not justified in patients who are not in CR, but even in this situation it is unknown whether PCI is necessary. The current therapeutic potentials seem to leave comparable fractions of patients without sufficient palliation of their symptomatic brain metastases regardless of whether or not PCI is given. Data from sufficiently large randomized trials have to be matured and analyzed, before the role of PCI in SCLC can be defined.
本文回顾了预防性颅脑照射（PCI）在小细胞肺癌（SCLC）治疗中的应用文献，重点关注截至1991年发表的十项随机试验。十项随机试验中有八项显示，接受PCI治疗的患者中枢神经系统复发频率有所降低，而没有一项试验显示PCI具有生存获益。目前的数据表明，生存仅在非常有限的患者亚组（完全缓解者的10%）中依赖于PCI的作用。人们普遍认为，未达到完全缓解（CR）的患者不适合接受PCI治疗，但即使在这种情况下，PCI是否必要也尚不清楚。无论是否给予PCI治疗，目前的治疗方法似乎都会使相当一部分患者的有症状脑转移无法得到充分缓解。在明确PCI在SCLC中的作用之前，必须对来自足够大型随机试验的数据进行完善和分析。
