Prophylactic Cranial Irradiation for Small-Cell Lung Cancer

These authors demonstrate definitively that prophylactic cranial irradiation prevents symptomatic brain metastases and prolongs survival.

Small-cell lung cancer (SCLC) carries a dismal prognosis. Fewer than 5% of patients survive 2 years from diagnosis, and patients with extensive SCLC survive for a median of 9 months. At least 18% of patients have brain metastases at diagnosis; the majority of other patients develop brain metastases during the course of the disease. To reduce the risk for brain metastases and to prolong survival in patients with limited SCLC and chemoresponsive tumors, many oncologists provide prophylactic cranial irradiation (PCI). However, the utility of PCI is unknown for patients with more extensive disease and chemotherapy-refractory tumors.

Researchers randomized 286 patients with extensive SCLC and any degree of chemotherapy response to receive PCI or …

Reviewing Author

Andrew Norden, MD