BMJ Support Palliat Care doi:10.1136/bmjspcare-2012-000356
  • Case report

Prophylactic cranial irradiation: 5 years on

  1. Derek G Power4
  1. 1Deparment of Neurology, Mercy University Hospital, Cork, Ireland
  2. 2Department of Palliative Medicine, Marymount University Hospice, Cork, Ireland
  3. 3Department of Radiotherapy, Cork University Hospital, Cork, Ireland
  4. 4Department of Medical Oncology, Mercy University Hospital, Cork, Ireland
  1. Correspondence to Dr Stephen A Ryan, Department of Neurology, Mercy University Hospital, Cork, Ireland; stephenryan0{at}


With advances in cancer management, patients are living with the long-term sequelae of both cancer and its treatment. This era of cancer survivorship poses unique challenges to the interdisciplinary cancer team in terms of management and prevention of treatment-related toxicities. This paper describes the case of a 55-year-old patient with neurocognitive disturbance as a result of prophylactic cranial irradiation (PCI). Five years after a diagnosis of small cell lung cancer, she is now an inpatient at a specialist palliative care unit. The current evidence for PCI and for potentially modifiable risk factors for neurocognitive disturbance as a consequence of PCI is explored.

  • Received 23 August 2012.
  • Revision received 29 November 2012.
  • Accepted 16 December 2012.
  • Published Online First 18 January 2013

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