Evolving Practice Patterns in the Use of Prophylactic Cranial Irradiation for Extensive-Stage Small Cell Lung Cancer

Olsi Gjyshi,Amy E Dursteler,David Boyce-Fappiano,Steven H Lin,Todd A Pezzi,Ethan B Ludmir,Timur Mitin

doi:10.1001/jamanetworkopen.2019.9135

Abstract

Evolving Practice Patterns in the Use of Prophylactic Cranial Irradiation for Extensive-Stage Small Cell Lung Cancer

Highlights

The recent phase 3 trial by Takahashi et al[1] showed no overall survival benefit with prophylactic cranial irradiation (PCI) over active magnetic resonance imaging (MRI) surveillance among patients with extensive-stage small cell lung cancer (ES-SCLC), questioning the previously established benefit of PCI for this patient group.[2]
Regression analysis showed no difference in likelihood of offering PCI based on practice setting, location, or size; volume of patients treated for lung cancer; or years in practice (Table)
Of the respondents not aware of the study by Takahashi et al,1 85% continued to offer PCI, a higher percentage than those who were aware of the study (Figure)

Summary

Introduction

The recent phase 3 trial by Takahashi et al[1] showed no overall survival benefit with prophylactic cranial irradiation (PCI) over active magnetic resonance imaging (MRI) surveillance among patients with extensive-stage small cell lung cancer (ES-SCLC), questioning the previously established benefit of PCI for this patient group.[2]. We conducted a nationwide survey study of radiation oncologists (ROs) to assess changes in the use of PCI for patients with ES-SCLC following publication of the trial by Takahashi et al.[1]

Methods

Results

Conclusion