Prospective evaluation of changes in computed cranial tomography in patients with small cell lung carcinoma treated with chemotherapy and prophylactic cranial irradiation.

Computed cranial tomographic scans were performed as part of the pretreatment evaluation and at six- to nine-month intervals posttreatment in 13 patients with small cell lung carcinoma. All patients received 3,000 rad of prophylactic cranial irradiation delivered over two weeks in ten treatment fractions in conjunction with multiagent chemotherapy. Posttreatment scans documented an extraordinarily high frequency of abnormalities including cerebral atrophy (100%), ventricular dilatation (70%), and decreased coefficient of absorption in the white matter (15%). Unexplained neurologic abnormalities developed in four of six patients living at least 15 months after institution of therapy. As the number of long-term survivors of this type of lung cancer increases, the need for prospective comprehensive neuropsychologic assessment to determine the clinical significance of these changes is needed.

[1]  W. Bowman,et al.  Serial cranial computed-tomography scans in children with leukemia given two different forms of central nervous system therapy. , 1983, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[2]  W. Schoene,et al.  Central nervous system changes after radiation therapy and/or chemotherapy: correlation of CT and autopsy findings. , 1983, AJNR. American journal of neuroradiology.

[3]  R. Makuch,et al.  Role of prophylactic cranial irradiation in prevention of central nervous system metastases in small cell lung cancer. Potential benefit restricted to patients with complete response. , 1983, The American journal of medicine.

[4]  Tewfik Hh,et al.  Cerebellar atrophy developing after cranial irradiation. , 1982 .

[5]  Y. Rinott,et al.  Long-lasting cerebral functional changes following moderate dose x-radiation treatment to the scalp in childhood: an electroencephalographic power spectral study. , 1982, Journal of neurology, neurosurgery, and psychiatry.

[6]  H. Moss,et al.  The effects of prophylactic treatment of the central nervous system on the intellectual functioning of children with acute lymphocytic leukemia. , 1981, The American journal of medicine.

[7]  R. Ivnik,et al.  Neuropsychologic Performance Among Children in Remission from Acute Lymphocytic Leukemia , 1981, Journal of developmental and behavioral pediatrics : JDBP.

[8]  J. Tepper,et al.  Follow-up neurological evaluation in patients with small cell lung carcinoma treated with prophylactic cranial irradiation and chemotherapy. , 1979, International journal of radiation oncology, biology, physics.

[9]  J. Dubé,et al.  Computed tomography brain scans in long term survivors of childhood acute lymphoblastic leukemia. , 1981, Medical and pediatric oncology.

[10]  P. F. Cooper,et al.  Distractibility and Memory Deficits in Long‐Term Survivors of Acute Lymphoblastic Leukemia , 1980, Journal of developmental and behavioral pediatrics : JDBP.

[11]  V. Smith,et al.  Therapeutic irradiation and brain injury. , 1980, International journal of radiation oncology, biology, physics.

[12]  R. Creech,et al.  "The state of the art" toward defining the role of radiation therapy in the management of small cell bronchogenic carcinoma. , 1980, International journal of radiation oncology, biology, physics.

[13]  A. Freeman,et al.  Computed tomography brain scans in children with acute lymphocytic leukemia receiving methotrexate alone as central nervous system prophylaxis , 1980, Cancer.

[14]  B. Ludwig,et al.  CT FOLLOW-UP STUDY OF 39 CHILDREN WITH LEUKEMIA TREATED BY CHEMOTHERAPY AND RADIOTHERAPY , 1979 .

[15]  M. Brennan.  Metabolic response to surgery in the cancer patient. Consequences of aggressive multimodality therapy , 1979, Cancer.

[16]  B. Shnider,et al.  Paraneoplastic syndromes: unusual manifestations of malignant disease. , 1979, Disease-a-month : DM.

[17]  R. Ivnik,et al.  Neuropsychologic follow‐up study of children with acute lymphocytic leukemia: A preliminary report , 1979, The American journal of pediatric hematology/oncology.

[18]  R C Holgate,et al.  Reversible cerebral atrophy in recently abstinent chronic alcoholics measured by computed tomography scans. , 1978, Science.

[19]  G. Chiro,et al.  Abnormal CT Scans of the Brain in Asymptomatic Children with Acute Lymphocytic Leukemia after Prophylactic Treatment of the Central Nervous System with Radiation and Intrathecal Chemotherapy , 1978 .

[20]  J Winter,et al.  Steroids and Apparent Cerebral Atrophy on Computed Tomography Scans , 1978, Journal of computer assisted tomography.

[21]  D. Enzmann,et al.  Cranial Computed Tomography Findings in Anorexia Nervosa , 1977, Journal of computer assisted tomography.

[22]  G. Chiro,et al.  White‐Gray Matter Differentiation in Computed Tomography , 1977, Journal of computer assisted tomography.

[23]  E. Heinz,et al.  Reversibility of Cerebral Atrophy in Anorexia Nervosa and Cushing's Syndrome , 1977, Journal of computer assisted tomography.

[24]  V. Young.  Energy metabolism and requirements in the cancer patient. , 1977, Cancer research.

[25]  C. Eiser,et al.  Retrospective study of intellectual development in children treated for acute lymphoblastic leukaemia. , 1977, Archives of disease in childhood.

[26]  C. Spurr,et al.  Prophylactic cranial irradiation in small cell carcinoma of the lung: A Randomized Study , 1977 .

[27]  Shapiro Wr.  Remote effects of Neoplasm on the central nervous system: encephalopathy. , 1976 .

[28]  R. Aur,et al.  Five years after central nervous system irradiation of children with leukemia. , 1976, International journal of radiation oncology, biology, physics.

[29]  S. Pitner,et al.  Effects of central-nervous-system irradiation on neuropsychologic functioning of children with acute lymphocytic leukemia. , 1975, The New England journal of medicine.

[30]  M. Huckman,et al.  The validity of criteria for the evaluation of cerebral atrophy by computed tomography. , 1975, Radiology.

[31]  S. Kramer,et al.  Complications of radiation therapy: the central nervous system. , 1974, Seminars in roentgenology.

[32]  Hansen Hh.  Should initial treatment of small cell carcinoma include systemic chemotherapy and brain irradiation , 1973 .

[33]  W. Hanafee,et al.  Atrophy following radiation therapy for central nervous system neoplasms. , 1972, Acta radiologica: therapy, physics, biology.

[34]  K. Momose,et al.  High incidence of cortical atrophy of the cerebral and cerebellar hemispheres in Cushing's disease. , 1971, Radiology.

[35]  J. Corsellis,et al.  "Limbic encephalitis" and its association with carcinoma. , 1968, Brain : a journal of neurology.

[36]  L. Brain,et al.  Subacute cerebellar degeneration associated with neoplasms. , 1965, Brain : a journal of neurology.