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Pro‐gastrin–releasing peptide as a factor predicting the incidence of brain metastasis in patients with small cell lung carcinoma with limited disease receiving prophylactic cranial irradiation
Author(s) -
Yonemori Kan,
Sumi Minako,
Fujimoto Naoko,
Ito Yoshinori,
Imai Atsushi,
Kagami Yoshikazu,
Ikeda Hiroshi
Publication year - 2005
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21238
Subject(s) - prophylactic cranial irradiation , medicine , brain metastasis , conventional pci , oncology , incidence (geometry) , univariate analysis , metastasis , small cell lung carcinoma , carcinoma , multivariate analysis , performance status , cancer , gastroenterology , surgery , small cell carcinoma , physics , myocardial infarction , optics
BACKGROUND Prophylactic cranial irradiation (PCI) reduces the incidence of brain metastasis with an effect on overall survival in patients with small cell lung carcinoma (SCLC). In spite of multidisciplinary intensive treatment approaches, many patients still experience brain metastasis. The authors retrospectively analyzed the characteristics of the first failure event due to brain metastasis (FBM) in patients treated with PCI. METHODS Between January 1990 and April 2004, 71 patients with limited disease SCLC were treated with PCI after completing systemic treatment at the National Cancer Center Hospital (Tokyo, Japan). Univariate and multivariate analyses were used to identify factors related to FBM and survival. RESULTS The FBM and overall incidence of brain metastasis (OBM) were 16.9 % (12 of 71) and 26.8% (19 of 71), respectively. Median time to progressive disease and median survival were 8.4 months and 21.6 months, respectively. Elevation of pro‐gastrin–releasing peptide (Pro GRP) level before PCI was found to be a significant predictive and prognostic factor for FBM, OBM, and survival on multivariate analysis ( P = 0.007, P = 0.025, and P = 0.009, respectively). CONCLUSIONS An elevated Pro GRP level before PCI was found to be significantly related to FBM and survival, and should be considered before PCI is performed. Cancer 2005. © 2005 American Cancer Society.