Prophylactic cranial irradiation in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts

Paul M. Putora; Markus Glatzer; Jose Belderbos; Benjamin Besse; Fiona Blackhall; Raffaele Califano; Federico Cappuzzo; Filippo de Marinis; Rafal Dziadziuszko; Enriqueta Felip; Corinne Faivre-Finn; Martin Fruh; Pilar Garrido; Cecila Le Pechoux; Fiona McDonald; Ursula Nestle; Silvia Novello; Mary O'Brien; Luis Paz Ares; Stephanie Peeters; Christoph Pottgen; Sara Ramella; Martin Reck; Ben Slotman; Esther G. C. Troost; Paul Van Houtte; Virginie Westeel; Joachim Widder; Francoise Mornex; Dirk De Ruysscher

doi:10.1016/j.radonc.2018.12.014

Prophylactic cranial irradiation in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts

Paul M. Putora^*, Markus Glatzer, Jose Belderbos, Benjamin Besse, Fiona Blackhall, Raffaele Califano, Federico Cappuzzo, Filippo de Marinis, Rafal Dziadziuszko, Enriqueta Felip, Corinne Faivre-Finn, Martin Fruh, Pilar Garrido, Cecila Le Pechoux, Fiona McDonald, Ursula Nestle, Silvia Novello, Mary O'Brien, Luis Paz Ares, Stephanie PeetersChristoph Pottgen, Sara Ramella, Martin Reck, Ben Slotman, Esther G. C. Troost, Paul Van Houtte, Virginie Westeel, Joachim Widder, Francoise Mornex, Dirk De Ruysscher

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Background: Due to conflicting results between major trials the role of prophylactic cranial irradiation (PCI) in stage IV small cell lung cancer (SCLC) is controversial.

Methods: We obtained a list of 13 European experts from both the European Society for Therapeutic Radiation Oncology (ESTRO) and the International Association for the Study of Lung Cancer (IASLC). The strategies in decision making for PCI in stage IV SCLC were collected. Decision trees were created representing these strategies. Analysis of consensus was performed with the objective consensus methodology.

Results: The factors associated with the recommendation for the use of PCI included the fitness of the patient, young age and good response to chemotherapy. PCI was recommended by the majority of experts for non-elderly fit patients who had at least a partial response (PR) to chemotherapy (for complete remission (CR) 85% of radiation oncologists and 69% of medical oncologists, for PR: 85% of radiation oncologists and 54% of medical oncologists). For patients with stable disease after chemotherapy, PCI was recommended by 6 out of 13 (46%) radiation oncologists and only 3 out of 13 medical oncologists (23%). For elderly fit patients with CR, a majority recommended PCI (62%) and no consensus was reached for patients with PR.

Conclusion: European radiation and medical oncologists specializing in lung cancer recommend PCI in selected patients and restrict its use primarily to fit, non-elderly patients who responded to chemotherapy. (C) 2018 Elsevier B.V. All rights reserved.

Original language	English
Pages (from-to)	163-166
Number of pages	4
Journal	Radiotherapy and Oncology
Volume	133
DOIs	https://doi.org/10.1016/j.radonc.2018.12.014
Publication status	Published - Apr 2019

Keywords

Small cell lung cancer
PCI
Stage IV
Expert opinion
ESTRO
IASLC
QUALITY-OF-LIFE
ONCOLOGY
TRIAL

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10.1016/j.radonc.2018.12.014

Cite this

Putora, P. M., Glatzer, M., Belderbos, J., Besse, B., Blackhall, F., Califano, R., Cappuzzo, F., de Marinis, F., Dziadziuszko, R., Felip, E., Faivre-Finn, C., Fruh, M., Garrido, P., Le Pechoux, C., McDonald, F., Nestle, U., Novello, S., O'Brien, M., Ares, L. P., ... De Ruysscher, D. (2019). Prophylactic cranial irradiation in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts. Radiotherapy and Oncology, 133, 163-166. https://doi.org/10.1016/j.radonc.2018.12.014

@article{0b2371136d7247b795f55d4c1d59c191,

title = "Prophylactic cranial irradiation in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts",

abstract = "Background: Due to conflicting results between major trials the role of prophylactic cranial irradiation (PCI) in stage IV small cell lung cancer (SCLC) is controversial.Methods: We obtained a list of 13 European experts from both the European Society for Therapeutic Radiation Oncology (ESTRO) and the International Association for the Study of Lung Cancer (IASLC). The strategies in decision making for PCI in stage IV SCLC were collected. Decision trees were created representing these strategies. Analysis of consensus was performed with the objective consensus methodology.Results: The factors associated with the recommendation for the use of PCI included the fitness of the patient, young age and good response to chemotherapy. PCI was recommended by the majority of experts for non-elderly fit patients who had at least a partial response (PR) to chemotherapy (for complete remission (CR) 85% of radiation oncologists and 69% of medical oncologists, for PR: 85% of radiation oncologists and 54% of medical oncologists). For patients with stable disease after chemotherapy, PCI was recommended by 6 out of 13 (46%) radiation oncologists and only 3 out of 13 medical oncologists (23%). For elderly fit patients with CR, a majority recommended PCI (62%) and no consensus was reached for patients with PR.Conclusion: European radiation and medical oncologists specializing in lung cancer recommend PCI in selected patients and restrict its use primarily to fit, non-elderly patients who responded to chemotherapy. (C) 2018 Elsevier B.V. All rights reserved.",

keywords = "Small cell lung cancer, PCI, Stage IV, Expert opinion, ESTRO, IASLC, QUALITY-OF-LIFE, ONCOLOGY, TRIAL",

author = "Putora, {Paul M.} and Markus Glatzer and Jose Belderbos and Benjamin Besse and Fiona Blackhall and Raffaele Califano and Federico Cappuzzo and {de Marinis}, Filippo and Rafal Dziadziuszko and Enriqueta Felip and Corinne Faivre-Finn and Martin Fruh and Pilar Garrido and {Le Pechoux}, Cecila and Fiona McDonald and Ursula Nestle and Silvia Novello and Mary O'Brien and Ares, {Luis Paz} and Stephanie Peeters and Christoph Pottgen and Sara Ramella and Martin Reck and Ben Slotman and Troost, {Esther G. C.} and {Van Houtte}, Paul and Virginie Westeel and Joachim Widder and Francoise Mornex and {De Ruysscher}, Dirk",

note = "Publisher Copyright: {\textcopyright} 2018 Elsevier B.V.",

year = "2019",

month = apr,

doi = "10.1016/j.radonc.2018.12.014",

language = "English",

volume = "133",

pages = "163--166",

journal = "Radiotherapy and Oncology",

issn = "0167-8140",

publisher = "Elsevier Ireland Ltd",

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Putora, PM, Glatzer, M, Belderbos, J, Besse, B, Blackhall, F, Califano, R, Cappuzzo, F, de Marinis, F, Dziadziuszko, R, Felip, E, Faivre-Finn, C, Fruh, M, Garrido, P, Le Pechoux, C, McDonald, F, Nestle, U, Novello, S, O'Brien, M, Ares, LP, Peeters, S, Pottgen, C, Ramella, S, Reck, M, Slotman, B, Troost, EGC, Van Houtte, P, Westeel, V, Widder, J, Mornex, F & De Ruysscher, D 2019, 'Prophylactic cranial irradiation in stage IV small cell lung cancer: Selection of patients amongst European IASLC and ESTRO experts', Radiotherapy and Oncology, vol. 133, pp. 163-166. https://doi.org/10.1016/j.radonc.2018.12.014

TY - JOUR

T1 - Prophylactic cranial irradiation in stage IV small cell lung cancer

T2 - Selection of patients amongst European IASLC and ESTRO experts

AU - Putora, Paul M.

AU - Glatzer, Markus

AU - Belderbos, Jose

AU - Besse, Benjamin

AU - Blackhall, Fiona

AU - Califano, Raffaele

AU - Cappuzzo, Federico

AU - de Marinis, Filippo

AU - Dziadziuszko, Rafal

AU - Felip, Enriqueta

AU - Faivre-Finn, Corinne

AU - Fruh, Martin

AU - Garrido, Pilar

AU - Le Pechoux, Cecila

AU - McDonald, Fiona

AU - Nestle, Ursula

AU - Novello, Silvia

AU - O'Brien, Mary

AU - Ares, Luis Paz

AU - Peeters, Stephanie

AU - Pottgen, Christoph

AU - Ramella, Sara

AU - Reck, Martin

AU - Slotman, Ben

AU - Troost, Esther G. C.

AU - Van Houtte, Paul

AU - Westeel, Virginie

AU - Widder, Joachim

AU - Mornex, Francoise

AU - De Ruysscher, Dirk

PY - 2019/4

Y1 - 2019/4

N2 - Background: Due to conflicting results between major trials the role of prophylactic cranial irradiation (PCI) in stage IV small cell lung cancer (SCLC) is controversial.Methods: We obtained a list of 13 European experts from both the European Society for Therapeutic Radiation Oncology (ESTRO) and the International Association for the Study of Lung Cancer (IASLC). The strategies in decision making for PCI in stage IV SCLC were collected. Decision trees were created representing these strategies. Analysis of consensus was performed with the objective consensus methodology.Results: The factors associated with the recommendation for the use of PCI included the fitness of the patient, young age and good response to chemotherapy. PCI was recommended by the majority of experts for non-elderly fit patients who had at least a partial response (PR) to chemotherapy (for complete remission (CR) 85% of radiation oncologists and 69% of medical oncologists, for PR: 85% of radiation oncologists and 54% of medical oncologists). For patients with stable disease after chemotherapy, PCI was recommended by 6 out of 13 (46%) radiation oncologists and only 3 out of 13 medical oncologists (23%). For elderly fit patients with CR, a majority recommended PCI (62%) and no consensus was reached for patients with PR.Conclusion: European radiation and medical oncologists specializing in lung cancer recommend PCI in selected patients and restrict its use primarily to fit, non-elderly patients who responded to chemotherapy. (C) 2018 Elsevier B.V. All rights reserved.

AB - Background: Due to conflicting results between major trials the role of prophylactic cranial irradiation (PCI) in stage IV small cell lung cancer (SCLC) is controversial.Methods: We obtained a list of 13 European experts from both the European Society for Therapeutic Radiation Oncology (ESTRO) and the International Association for the Study of Lung Cancer (IASLC). The strategies in decision making for PCI in stage IV SCLC were collected. Decision trees were created representing these strategies. Analysis of consensus was performed with the objective consensus methodology.Results: The factors associated with the recommendation for the use of PCI included the fitness of the patient, young age and good response to chemotherapy. PCI was recommended by the majority of experts for non-elderly fit patients who had at least a partial response (PR) to chemotherapy (for complete remission (CR) 85% of radiation oncologists and 69% of medical oncologists, for PR: 85% of radiation oncologists and 54% of medical oncologists). For patients with stable disease after chemotherapy, PCI was recommended by 6 out of 13 (46%) radiation oncologists and only 3 out of 13 medical oncologists (23%). For elderly fit patients with CR, a majority recommended PCI (62%) and no consensus was reached for patients with PR.Conclusion: European radiation and medical oncologists specializing in lung cancer recommend PCI in selected patients and restrict its use primarily to fit, non-elderly patients who responded to chemotherapy. (C) 2018 Elsevier B.V. All rights reserved.

KW - Small cell lung cancer

KW - PCI

KW - Stage IV

KW - Expert opinion

KW - ESTRO

KW - IASLC

KW - QUALITY-OF-LIFE

KW - ONCOLOGY

KW - TRIAL

U2 - 10.1016/j.radonc.2018.12.014

DO - 10.1016/j.radonc.2018.12.014

M3 - Article

C2 - 30935574

SN - 0167-8140

VL - 133

SP - 163

EP - 166

JO - Radiotherapy and Oncology

JF - Radiotherapy and Oncology

ER -