【摘 要】
：
Lung cancer remains the leading cause of cancer death in the United States and worldwide.More than 200,000 Americans died every year of lung cancer.At the time of presentation of Non-Small Cell Lung C
【机 构】
：
Medicine University of Colorado Denver USA
【出 处】
：
BITs 3rd Annual World Cancer Congress-2012(2012第五届世界癌症大会)
论文部分内容阅读
Lung cancer remains the leading cause of cancer death in the United States and worldwide.More than 200,000 Americans died every year of lung cancer.At the time of presentation of Non-Small Cell Lung Cancer (NSCLC),80% of patients present with advanced or metastatic disease.Brain metastasis in NSCLC is a devastating problem with strong impact in the quality of life and survival of patients.Prophylactic cranial irradiation (PCI) has been standard of care for Small Cell Lung Cancer for several years already, however its role as prophylaxis in NSCLC remains still unclear.There are several studies evaluating the use of PCI in this group.The first studies conducted more than 2 decades ago lacked to show a convincing benefit, however, advances in surgical and radiation technique could potentially translate in improvement of these results.Newer studies have shown that PCI decrease the rate of brain metastasis,but there is lack of benefit in progression-free survival and overall survival.Currently, brain disease progression is frequently seen as initial failure site during successful treatment with targeted therapy, specifically with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI).Patients getting benefit from EGFR TKI with CNS failure can show durable extracranial control after cranial progression.Prophylactic cranial irradiation could be useful,especially in the subset of high risk patients with NSCLC to develop brain metastasis.
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