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Brain Irradiation Decreases Incidence of Brain Metastases in Locally Advanced Lung Cancer Patients

By MedImaging International staff writers
Posted on 16 Jun 2009

Patients with locally advanced lung cancer who received a course of radiation therapy to their brain at the completion of their lung cancer treatment were less likely to develop brain metastases within the first year after treatment, according to new research.

Findings from the Radiation Therapy Oncology Group (RTOG; Philadelphia, PA, USA) study were presented at the American Society of Clinical Oncology annual meeting in Orlando, FL, USA, on June 1, 2009. RTOG, a U.S. National Cancer Institute- (NCI)-funded national clinical trials group, is a clinical research component of the American College of Radiology (ACR; Philadelphia. PA, USA).

As the treatment for locally advanced non-small cell lung cancer has improved, researchers are finding that patients have an increased risk of developing brain metastases without a relapse of their lung cancer. In order to develop a consensus on how to address this risk, RTOG initiated a phase III study to compare prophylactic cranial irradiation (PCI) versus observation in this patient population. Although the study, RTOG 0214, closed without meeting its accrual objective, an analysis of the 356 patients entered on the study found that patients who did not receive PCI were two and a half times more likely to develop brain metastases than those who did receive PCI.

"Although this study did not show a statistically significant difference in survival between the two groups of patients, we were able to show that PCI significantly decreased the incidence of brain metastases during the first year post-treatment,” said Elizabeth Gore, M.D., the lead author and principal investigator of the RTOG study from the Medical College of Wisconsin (Milwaukee, USA). "We plan a future analysis of the impact of PCI on neuropsychological function and quality of life and we expect that analysis will influence the recommendations regarding the standard use of PCI.”

RTOG is a multi-institutional international clinical cooperative group that conducts clinical trials and is comprised of over 300 major research institutions in the United States, Canada, and internationally. The group is currently accruing to 40 studies that involve radiation therapy alone or in conjunction with surgery and/or chemotherapeutic drugs or investigate quality of life issues and their effects on the cancer patient.

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68 (!!!!! 6527.9006958008): SELECT fid FROM jos_deeppockets WHERE id=294723922 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294723922 AND published='1' LIMIT 1

69 (!!!!! 1778.8410186768): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (!!!!! 2096.8914031982): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (125.88500976562): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (237.94174194336): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (552.89268493652): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (247.00164794922): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (231.98127746582): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (224.11346435547): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (174.04556274414): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (182.8670501709): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (97.990036010742): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (226.97448730469): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (412.94097900391): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (327.82554626465): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (138.99803161621): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 1582.145690918): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (177.86026000977): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (37.908554077148): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (!!!!! 1894.9508666992): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (166.17774963379): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (262.97569274902): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (217.91458129883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (927.92510986328): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (251.05476379395): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (164.98565673828): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (263.92936706543): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (334.02442932129): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (145.91217041016): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (73.909759521484): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (782.01293945312): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (264.88304138184): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1978.874206543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

105 (890.01655578613): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

106 (454.18739318848): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294723922 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1109.8384857178): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294723922 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 2865.7913208008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

109 (324.01084899902): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

110 (777.00614929199): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294723922 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (937.22343444824): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294723922 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 2650.9761810303): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (790.11917114258): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (!!!!! 2864.1223907471): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

115 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

116 (49.829483032227): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

117 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

118 (618.93463134766): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

119 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

120 (43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

121 (34.809112548828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

122 (143.05114746094): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 113509.89341736): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (760.07843017578): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723922 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723922 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 30847.072601318): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 1209.9742889404): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (45.061111450195): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (38.14697265625): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (29.087066650391): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (316.85829162598): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (40.054321289062): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (500.20217895508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 2487.8978729248): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (!!!!! 1460.075378418): SELECT name FROM jos_deeppockets WHERE id=211

138 (!!!!! 1605.0338745117): SELECT name FROM jos_deeppockets WHERE id=211

139 (773.90670776367): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (!!!!! 1141.0713195801): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (349.99847412109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

142 (!!!!! 3696.9184875488): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

143 (!!!!! 9330.9879302979): TRUNCATE TABLE jos_trademed_module

144 (88.930130004883): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294723922 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (51.975250244141): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294723922 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (!!!!! 2120.9716796875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (60.796737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

149 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

150 (!!!!! 1178.0261993408): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (225.06713867188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

152 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

153 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294723922 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294723922 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (294.20852661133): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (77.009201049805): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (!!!!! 4644.8707580566): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (362.87307739258): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

158 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294723922 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294723922 AND published='1' LIMIT 1

159 (114.91775512695): select jos_twitters.link from jos_twitters where cat=10

160 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

161 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

162 (27.179718017578): select jos_linkedin.link from jos_linkedin where cat=10

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