What is PCI?

[rmm17]

I have heard a lot about PCI on this site, but i'm not sure what it is. My mom's dr. has not mentioned it?

[SDianneB]

PCI = prophylactic (preventive) cranial irradiation

It's brain radiation given in a lower dose than usual, and fewer treatments.

It's often given in small cell patients if the original chest tumor is in remission. I was told that there is a 50% chance of spread to the brain, and having PCI can reduce that down to less than 10% in many patients, so I chose to have it. Not everyone is a candidate, obviously, so this is something to ask your docs about and ask lots of questions before making a decision.

Much luck to you!

Di

[john]

Prophalactic Cranial Irradiation

Basically it is radiation given when there is no evidence of a brain tumor.

Since SCLC often metastasizes to the brain, the radiation is given to prevent brain mets.

It is generally only often to limited SCLC that has had a complete response to treatment.

Most of the studies show a 10% or so improvement in 5 year survival

In one study brain mets were found in 32.0% vs 3.8% of patients who received PCI

http://www.cmj.org/information/full.asp?id=2155

[Cindy RN]

The stats are different wherever you look on long term prevention of mets to the brain after PCI.

Please look into it before it is done. Not everyone does it. There are several on here that have-ask them, I did not have it done. There are some side effects that can be severe. Not all have them-thank goodness.

Be informed before having a Dr just say you need this. This goes for ANYTHING ordered.

Cindy

[berisa]

PCI cannot guarantee no brain mets will be happened. My dad was the living case. He had the brain mets too after PCI. For me, PCI didn't do any good to him as he started to feel weak and uncomfortable after PCI...never bouncing back to the days receiving chemo. But PCI is a standard treatment to SCLC patients especially limited SCLC patients. It's really difficult to prove its effectiveness as there is no what-if in each case. No pre-assumptions can be made.

You should ask the oncologist as they are more professional than us.

[john]

That studies seem to show better control (fewer brain mets) with PCI versus no PCI.

Unfortunately nothing is 100% with lung cancer.

PCI seems to reduce the risk of developing a brain met from 37% or so to 20%. The studies are meta-analysis, looking at past results so it is not as good of a study as a true clinical trial.

There was some research of a peptide called Pro gastrin releasing peptide. Those with an elevated level had less benefit from PCI.

I am not sure of the validity of the study, but your Dr should provide you with all the pros and CONS.

It isnt any easy decision, but get as much info as you can

[daggiesmom]

I didn't have this treatment. So far, no mets have appeared (3 1/2 years). This seems to be a very individual decision that must be weighed against the potential side effects and damage. Talk about it alot with your Mom's doctor.

Joanie

[SDianneB]

Also, if you're being treated at a cancer center, try and find out their specific history with and without PCI. Where I am being treated, their success rate with PCI on small cell patients is higher than some of the studies I've read, yet the Radiation Oncologists there say their results mirror those in similar facilities (such as Vanderbilt which is nearby). The rate he told me was that there is a 50% chance of brain mets, and PCI reduces that to less than 10%. To me, it was more than enough to convince me to go ahead with it, and I've suffered no ill effects from it so far.

Like everyone has said, it's a highly individual decision, and one that deserves much thought and asking lots and lots of questions.

My goal when I started out was to maximize my survival. I felt like the PCI was one more tool to help me do that. So far, I was right. How long that will last, I have no idea, but given what I'm fighting, it surely wasn't a negative thing for me to have done.

Di