Practice guideline on prophylactic cranial irradiation in small-cell lung cancer

Treatment outcomes of patients with small cell lung cancer without prophylactic cranial irradiation

“…For patients achieving CR or near-CR after initial therapy, prompt PCI is widely known as the standard treatment (13,14). Regarding doses of whole-brain irradiation, even increased radiation doses do not improve outcomes, and the standard dose is 25 Gy in ten daily fractions of 2.5 Gy each (15).…”

“…In patients with SCLC, prophylactic cranial irradiation (PCI) is reported to improve prognosis (3). The effects of PCI have been investigated in many clinical studies, and this modality has been incorporated into standard treatment regimen (13,14). PCI is indicated for patients with LD who have achieved complete remission (CR) or near-CR with initial chemotherapy and radiotherapy.…”

Surgery and Chemotherapy for Small Cell Lung Cancer in Stages I–II with or without Radiotherapy

“…Approximately half of patients will develop brain metastases at some point during the course of disease. If cases from autopsy series are included, CNS metastases can be as high as 80% at 2 years [3,4,16]. PCI improves overall survival by ~5% at 3 years and decreases the cumulative incidence of brain metastasis to 50% among patients in complete remission [3,19].…”

“…Brain metastases are a common cause of treatment failure. Prophylactic cranial irradiation (PCI) is recommended in patients with LSCLC who achieve a complete response after chemoradiotherapy [3,16,19]. However, the median survival after chemoradiotherapy is 20 months, and only 30% of patients with LSCLC survive 2 years after the initial diagnosis [4,8,14].…”

Combined Treatment Modality in Small Cell Lung Cancer

“…The current recommendation is to start prophylactic treatment as soon as possible after completion of chemotherapy [25]. Magnetic resonance tomography studies of the neurocranium showed that up to 30% of these patients have undetected, asymptomatic brain metastases at this time [27].…”