Prophylactic cranial irradiation following surgical resection of early-stage small-cell lung cancer: A review of the literature

Brooke C. Bloom, Alexander Augustyn, Boris Sepesi, Sunil Patel, Shalin J. Shah, Ritsuko U. Komaki, Steven E. Schild, Stephen G. Chun

Research output: Contribution to journalShort surveypeer-review

6 Scopus citations

Abstract

With increasing use of low-dose screening CT scans, the diagnosis of early-stage small-cell lung cancer (SCLC) without evidence of mediastinal nodal or distant metastasis is likely to become more common, but the role of adjuvant therapies such as prophylactic cranial irradiation (PCI) are not well understood in this population. We performed a review of the literature pertaining to the impact of PCI in patients who underwent surgical resection of early-stage SCLC. Four studies were identified that were pertinent including three single-institution retrospective analyses and a National Cancer Database analysis. Based upon these studies, we estimate the rate of brain metastases to be 10-15% for Stage I and 15-25% for Stage II disease without PCI. However, the impact of PCI on the development of brain metastases and its ultimate impact on overall survival were not consistent across these studies. In summary, there is sparse evidence to guide recommendations for PCI following resection of early-stage SCLC. While it may be reasonable to offer PCI to maximize likelihood of cure, alternative strategies such as observation with close imaging follow-up can also be considered for the appropriate patient given the known neurocognitive side effects of PCI.

Original languageEnglish (US)
Article number228
JournalFrontiers in Oncology
Volume7
Issue numberSEP
DOIs
StatePublished - Sep 29 2017

Keywords

  • Brain metastasis
  • Early stage
  • Prophylactic cranial irradiation
  • Small-cell lung cancer
  • Surgical resection

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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