Prophylactic cranial irradiation should  be considered as standard of care for patients with extensive small-cell lung cancer  who respond to chemotherapy 


Prophylactic cranial irradiation (PCI) is part of standard of care in patients with limited SCLC who have reached a complete remission after chemotherapy. The presumption has been that PCI would not be of benefit for patients with extensive SCLC, due to their short life expectancy. However, this randomized, controlled trial shows that in patients with extensive disease SCLC, PCI leads to a significant reduction in the risk of symptomatic brain metastases without compromising quality of life. In addition, PCI was associated with a doubling in 1-year survival. Prophylactic cranial irradiation should now be considered as standard of care for patients with extensive SCLC who respond to chemotherapy.

 

Bibliographic reference:

Slotman B et al.:  "Prophylactic cranial irradiation in extensive small-cell lung cancer". N Engl J Med. 2007 Aug 16;357(7):664-72

 

Ben Slotman

Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands