Publication

Extrapulmonary small cell carcinoma: An indication for prophylactic cranial irradiation? A single center experience

Journal Paper/Review - Jun 27, 2011

Units
PubMed
Doi

Citation
Früh M, Kacsir B, ess s, Cerny T, Rodriguez R, Plasswilm L. Extrapulmonary small cell carcinoma: An indication for prophylactic cranial irradiation? A single center experience. Strahlenther Onkol 2011; 187:561-7.
Type
Journal Paper/Review (English)
Journal
Strahlenther Onkol 2011; 187
Publication Date
Jun 27, 2011
Issn Electronic
1439-099X
Pages
561-7
Brief description/objective

BACKGROUND
Information about extrapulmonary small cell carcinoma (EPSCC) is limited and the role of prophylactic cranial irradiation (PCI) is unknown.

PATIENTS AND METHODS
Disease presentation and outcome of all EPSCC at our hospital between 1990 and 2009 were retrospectively analyzed.

RESULTS
Of 30 EPSCC, the male:female ratio was 58%:42%; 83% had a performance status of 0-2. Median age was 71 years (32-80). Seventeen (57%) had limited stage (LS), 13 (43%) extensive stage (ES). The location of the primary tumor was gastrointestinal (n = 8), unknown (6), gynecological (6), urogenital (5), and ear nose throat (5). Four (13%) developed brain metastases (2 ES, 2 LS). In ES, first line chemotherapy (CT) was given in 85%, mostly platinum-etoposide (64%). Response rate was 90%. In LS, CT and radiotherapy (RT) ± resection resulted in persistent remissions in 67% of patients. Median survival was 16 months (1-107 months), 18 months (1-107 months), and 9 months (0.4-25 months) for LS + ES, LS, and ES, respectively. Weight loss ≥5 % and ECOG performance status 3 + 4 were associated with poorer survival (p < 0.001 and p < 0.01, respectively).

CONCLUSION
The incidence of brain metastases was relatively low (13%). More studies are necessary, before routinely offering PCI to patients with EPSCC. Best survival outcomes in LS were achieved with multimodality treatment including CT and RT. Prognosis was poor in patients with ES.