Neurotoxicity of prophylactic cranial irradiation in patients with small cell carcinoma of the lung

This study is concerned with effects of prophylactic cranial irradiation on neurological and mental functioning of patients with small cell cancer of the lung. Results are reported of a pilot study in two parts. In a prospective clinical-neurological study, 14 patients with small cell cancer of the lung were evaluated with standard neurological and bedside mental status examinations, before and after irradiation. Their performance was compared with evaluation results of seven small cell cancer of the lung patients who received no irradiation. Dysfunctions were exclusively found in the irradiated patients, which are interpreted as a contributional effect of prophylactic cranial irradiation. Results are reported of further neuropsychological investigation in a sample of five prophylactic cranial irradiation patients. The presence of a rather specific pattern of neuropsychic deficits was confirmed. Areas of malfunctioning were described with some clinical and research implications. (author)