PCI for SCLC with history of ataxia and small seizures - 1268474

midwest
Posts:4

Good Morning, a quick question on your opinion of PCI for someone with a history of ataxia and small seizures,along with slurred speech.

20 years ago I had this for several years, went to Mayo Clinic and was told it was the beginning of MS, that a very small percentage of people acquire. I have not had any problems since 1999, however, now I have SCLC ext. ( no brain mets.) and am scheduled for PCI within the next two weeks, and I have some serious concerns about having it.
Any input would be greatly appreciated.

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Reply # - February 13, 2015, 07:55 AM

JimC
Posts: 2753

Hello,

Welcome to GRACE. Dr. West has written a post describing the use of PCI in SCLC which you can read here. There is also a more recent podcast in which members of the GRACE faculty discuss which patients should receive PCI.

You may also find this post on the side effects of WBR/PCI helpful.

JimC
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Reply # - February 13, 2015, 09:37 PM

Dr West
Posts: 4735

One Japanese study presented at a major meeting last year demonstrated a worse survival for patients with extensive SCLC who received PCI compared with those who did not. This is the opposite of the result seen in an earlier study from Europe that led to the recommendation to sometimes recommend it.

Because there is some risk of cognitive deficits in anyone who receives PCI, there would typically be greater concern about PCI in someone with any pre-existing neurologic diagnosis that could lower the compensatory mechanisms with PCI. At the same time, though we haven't figured out why a Japanese study would show a harmful effect of PCI for extensive SCLC after a European study showed a benefit, the net result is that the Japanese study has led to diminished enthusiasm for the approach, given the uncertainty around the benefit.

Good luck.

-Dr. West

Reply # - February 14, 2015, 03:31 PM

midwest
Posts: 4

Thank you for your reply.

I am still weighing the pro's and con''s , after reading your post I am leaning towards not doing it
I did call my radiologist and the nurse spoke with him, it indicated he thought it would be okay, but no guarantee on something not happening. I have an appointment on Tuesday to see him. But am doing some praying for the right answer, SCLC ext. is a large enough problem without adding to it.

Reply # - February 18, 2015, 11:08 AM

midwest
Posts: 4

Had a visit to radiologist yesterday and he also agreed that the risk far outweighed the value in my situation.
I will have chest and lung radiation, as I have been stable (after a 50% decrease in size) and that may help extend my time.

Reply # - February 18, 2015, 11:40 AM

catdander
Posts:

HI midwest, I'm glad you and your radiation oncologist have made a decision. I know that feeling of purpose after making a treatment decision is a relief.
All the best of luck,
Janine

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