Reducing Neurocognitive Impairment In Treating Limited Stage Small Cell Lung Cancer with Gamma Knife Radiosurgery
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Date
2023-07-31
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Authors
Cunningham, Andrew
Behm, Hayley
Ju, Andrew
Peach, Matthew
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Abstract
Small Cell Lung Cancer (SCLC) represents 15% of lung cancer and is characterized by rapid growth with metastasis resulting in poor survival rates.1 SCLC with a limited stage defined as disease limited to the hemithorax with no evidence of current metastasis.2 The current gold standard includes chemoradiation and prophylactic cranial irradiation (PCI)3,4 which can result in acute adverse effects that do not improve over time.2 These include long-term toxicity with neurocognitive impairment, decrease short term memory and change in personality. An alternative treatment is the implementation of a watchful waiting strategy utilizing Gamma Knife Radiosurgery on a single or a few metastatic lesions as they appear. With Gamma Knife Radiosurgery, treating small lesions to a high dose with little irradiation to the rest of the brain does not result in cognitive side effects. Patients are subjected to close image surveillance of serial MRIs monthly to determine if Gamma Knife is necessary.