Format

Send to

Choose Destination
See comment in PubMed Commons below
Strahlenther Onkol. 2012 Jun;188(6):478-82. doi: 10.1007/s00066-012-0084-5. Epub 2012 Mar 16.

Cerebral metastases in extrapulmonary cell carcinoma. Implications for the use of prophylactic cranial irradiation.

Author information

1
Department of Radiooncology, Eberhard-Karls-University Tübingen, Tübingen, Germany. franziska.eckert@med.uni-tuebingen.de

Abstract

BACKGROUND AND PURPOSE:

Extrapulmonary small cell carcinoma (EPSCC) is a rare disease. Standard treatment is performed in analogy to small cell lung cancer; however, due to the differences in rates of cerebral metastases (CM), prophylactic cranial irradiation (PCI) is not routinely used. Therefore, we evaluated the characteristics of all patients developing brain metastases in a population of EPSCC patients and calculated a number needed to treat (NNT) for the prevention of cerebral metastases by PCI.

PATIENTS, METHODS, AND RESULTS:

Of 51 patients treated at our institution from 1999-2011 for EPSCC, 11 presented with CM, 5 at initial diagnosis, 6 in the course of their disease. Median overall survival after primary diagnosis of EPSCC was 12 months. Overall survival after diagnosis of CM was significantly in favor of primarily cerebrally metastasized patients with 9 compared to 2 months for secondary CM (p = 0.04), median survival for all patients being 4 months. The NNT calculation was based on the 6 patients with secondary brain metastases in our series and a relative risk reduction of 60% observed in the studies of PCI for small cell lung cancer (SCLC), resulting in an NNT of 13.

CONCLUSION:

Although the frequency of brain metastases in EPSCC was lower than in SCLC, the NNT of 13 for the prevention of CM, as well as the poor median survival after diagnosis of secondary brain metastases of 2 months might be a reason to discuss and evaluate PCI for EPSCC patients responding to initial therapy.

PMID:
22418588
DOI:
10.1007/s00066-012-0084-5
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Support Center