- Receiving prophylactic cranial irradiation (PCI) after thoracic radiation is not associated with decreased risk for brain metastases or improved OS in patients with limited-stage (LS) small-cell lung cancer (SCLC) whose disease is staged with MRI.
Why this matters
- Although some national guidelines recommend PCI in some patients with SCLC, the recommendation is based on studies conducted before the use of MRI for staging became more routine.
- 297 patients with LS-SCLC underwent thoracic radiation, followed by PCI (n=205) or not (n=92).
- Propensity matching with 84 patient pairs.
- Funding: None disclosed.
- Median thoracic radiation treatment dose was 45.0 Gy in both groups.
- Complete or partial response to radiation therapy was reported in 91.4% of the no-PCI and 94.9% of the PCI group.
- After propensity matching, unadjusted incidence rate of brain metastases was higher in the no-PCI than the PCI group, but not significantly so (20.40% vs 11.20%; P=.10).
- After multivariable analysis, PCI was not associated with a decreased risk for brain metastases (adjusted HR, 0.513; P=.09) or improved OS (adjusted HR, 0.787; P=.17).
- Single-center, retrospective study.