- Prophylactic cranial irradiation (PCI) is associated with a significantly lower incidence of brain metastases in patients with NSCLC, especially in patients with good performance status, but offers no survival benefit.
Why this matters
- Although earlier studies suggested an association of PCI with significantly decreased incidence of brain metastases, data on the survival benefit have been conflicting.
- Meta-analysis of 7 studies with 1462 patients with NSCLC who received PCI (n=717) or no PCI (n=745).
- Funding: National Natural Science Foundation of China.
- Receipt of PCI was associated with a significantly lower incidence of brain metastases:
- Relative risk, 0.37 (95% CI, 0.26-0.52).
- Receipt of PCI was not associated with improved OS:
- Pooled HR, 1.01 (95% CI, 0.87-1.22).
- PCI was associated with a significant decrease in brain metastases in patients with good performance status:
- HR, 0.21 (95% CI, 0.10-0.47).
- PCI-related toxicities and adverse events were considered minor and included alopecia, headache, fatigue, skin toxicity, nausea, and vomiting.
- 1 study reported a high incidence of cognitive impairment, but there were no reports of negative QoL resulting from PCI-related adverse events.
- Retrospective study with potential risk bias.