Leukoencephalopathy in small cell lung cancer patients receiving prophylactic cranial irradiation

S. Frytak, J. N. Shaw, Brian Patrick O'Neill, R. E. Lee, R. T. Eagan, E. G. Shaw, R. L. Richardson, D. T. Coles, J. R. Jett

Research output: Contribution to journalArticle

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Abstract

The cases of 283 small cell lung cancer patients who received treatment with combination chemotherapy with or without prophylactic cranial irradiation (PCI) were reviewed to determine the incidence of leukoencephalopathy. The overall incidence was 10%. Of all patients receiving PCI, 17% developed neurotoxicity, and of those receiving PCI and surviving ≥ 1.5 years, 37% suffered neurologic sequelae. In those receiving PCI but surviving < 1.5 years, the incidence of neurotoxicity was 4%. The mean time interval between the end of PCI and the onset of neurotoxicity was 17 months (range 2-63 months). The PCI dose ranged from 2600-3600 cGy. None of the patients not receiving PCI developed neurotoxicity. The incidence of neurotoxicity in long-term survivors (≥ 1.5 years) with respect to PCI dose was ≤ 3000 cGy (25%), 3200 cGy (56%), 3600 cGy (36%). Almost all of the patients getting PCI also received lomustine, an agent associated with DNA repair inhibition and synergism with DNA damaging agents such as ionizing radiation or alkylating agents. Under the conditions of our study, PCI was associated with an unacceptable risk of neurotoxicity. Until further information is forthcoming, one should proceed with caution when using PCI in conjunction with lomustine.

Original languageEnglish (US)
Pages (from-to)27-33
Number of pages7
JournalAmerican Journal of Clinical Oncology: Cancer Clinical Trials
Volume12
Issue number1
StatePublished - 1989

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Cranial Irradiation
Leukoencephalopathies
Small Cell Lung Carcinoma
Lomustine
Incidence
Alkylating Agents
Ionizing Radiation
Combination Drug Therapy
DNA Repair
Nervous System
Survivors

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Leukoencephalopathy in small cell lung cancer patients receiving prophylactic cranial irradiation. / Frytak, S.; Shaw, J. N.; O'Neill, Brian Patrick; Lee, R. E.; Eagan, R. T.; Shaw, E. G.; Richardson, R. L.; Coles, D. T.; Jett, J. R.

In: American Journal of Clinical Oncology: Cancer Clinical Trials, Vol. 12, No. 1, 1989, p. 27-33.

Research output: Contribution to journalArticle

Frytak, S, Shaw, JN, O'Neill, BP, Lee, RE, Eagan, RT, Shaw, EG, Richardson, RL, Coles, DT & Jett, JR 1989, 'Leukoencephalopathy in small cell lung cancer patients receiving prophylactic cranial irradiation', American Journal of Clinical Oncology: Cancer Clinical Trials, vol. 12, no. 1, pp. 27-33.
Frytak, S. ; Shaw, J. N. ; O'Neill, Brian Patrick ; Lee, R. E. ; Eagan, R. T. ; Shaw, E. G. ; Richardson, R. L. ; Coles, D. T. ; Jett, J. R. / Leukoencephalopathy in small cell lung cancer patients receiving prophylactic cranial irradiation. In: American Journal of Clinical Oncology: Cancer Clinical Trials. 1989 ; Vol. 12, No. 1. pp. 27-33.
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