Social consequences of brain or liver relapse in small cell carcinoma of the bronchus

• Published in: Radiotherapy and oncology Vol. 4; no. 4; pp. 335 - 339
• Main Authors: Felletti, Raffaella, Souhami, Robert L., Spiro, Stephen G., Geddes, Duncan M., Tobias, Jeffrey S., Mantell, Brian S., Harper, Peter G., Trask, Colin
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.12.1985
• Subjects: Adult; Aged; Brain Neoplasms - psychology; Brain Neoplasms - secondary; Brain relapse; Carcinoma, Small Cell - psychology; Carcinoma, Small Cell - radiotherapy; Carcinoma, Small Cell - secondary; Combined Modality Therapy; Female; Humans; Length of Stay; Liver Neoplasms - psychology; Liver Neoplasms - secondary; Liver relapse; Lung Neoplasms - psychology; Lung Neoplasms - radiotherapy; Male; Middle Aged; Neurocognitive Disorders - psychology; Prognosis; Small cell carcinoma of the lung; Social Adjustment; Social Support; Liver relapse; Small cell carcinoma of the lung; Brain relapse
• ISSN: 0167-8140; 1879-0887
• DOI: 10.1016/S0167-8140(85)80121-3

The time spent in hospital when cerebral metastases occur ás the first site of relapse in patients with small cell carcinoma of the lung (SCCL) has been analysed and compared to the consequences of relapse in the liver. In the course of a clinical trial with 370 patients, 50 patients relapsed initially in the brain and 20 in the liver. The 2 groups were comparable with respect to performance status at diagnosis and the amount of home support available. Patients who relapsed in the brain suffered a greater deterioration in performance status, and spent a greater proportion of their remaining life in hospital than did patients whose initial relapse was in the liver. This difference was most marked in patients who died soon after relapse. Radiotherapy (20 Gy in 5 fractions over one week or 30 Gy in 10 fractions over 2 weeks) and dexamethasone were not very effective treatments for brain relapse though subjective responses were common. The substantial morbidity and lengthy hospitalisation resulting from brain relapse compared with relapse at another site is a important factor to be considered in assessing whether prophylactic cranial irradiation should routinely be offered to patients with SCCL.