Abstract
Small-cell lung cancer (SCLC) is a highly aggressive malignant tumor that is prone to lead to the development of brain metastases (BM). The application of prophylactic cranial irradiation (PCI) has been regarded as an important technological advance made in cancer therapy to reduce the occurrence of BM and improve patient survival. The benefits of PCI in the treatment of limited-stage SCLC have been confirmed. However, there has been continuous controversy about the indications and advantages of PCI for extensive-stage SCLC (ES-SCLC) because of the conflicting results from two prospective trials. In this review, we aimed to discuss the relevant controversy and progress made in the clinical application of PCI in ES-SCLC.
Highlights
Small-cell lung cancer (SCLC) accounts for only 13% of all newly diagnosed lung cancers [1] and has distinct pathological, clinical, and molecular characteristics from those of non-small-cell lung cancer (NSCLC)
Studies have shown that craniocerebral magnetic resonance imaging (MRI) can improve the detection rate of subclinical lesions in SCLC, and that prophylactic cranial irradiation (PCI) can reduce the incidence of brain metastases (BM) in patients with ESSCLC
Regular follow-up MRI and salvage stereotactic body radiation therapy (SBRT) after BM are the modalities used for SCLC treatment
Summary
Small-cell lung cancer (SCLC) is a highly aggressive malignant tumor that is prone to lead to the development of brain metastases (BM). The application of prophylactic cranial irradiation (PCI) has been regarded as an important technological advance made in cancer therapy to reduce the occurrence of BM and improve patient survival. The benefits of PCI in the treatment of limited-stage SCLC have been confirmed. There has been continuous controversy about the indications and advantages of PCI for extensive-stage SCLC (ES-SCLC) because of the conflicting results from two prospective trials. We aimed to discuss the relevant controversy and progress made in the clinical application of PCI in ES-SCLC
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