Outcomes of prophylactic cranial irradiation in patients with small cell lung cancer in the modern era of baseline magnetic resonance imaging of the brain

• DOI: 10.1080/0284186x.2021.1974553
• Publication Date: 2021-09-29T03:47:47Z
• Authors: Mads Kjaergaard Held; Olfred Hansen; Tine Schytte; Karin Holmskov Ha...; Rana Bahij; Morten Nielsen; Tine Bjørn Nielsen; Stefan Starup Jep...
• Keywords: Prophylactic cranial irradiation; Clinical endpoint

For decades many patients with small cell lung cancer (SCLC) have been offered prophylactic cranial irradiation (PCI) to prevent brain metastases (BM). However, the role of PCI is debated in modern era increased magnetic resonance imaging (MRI) availability. BM SCLC may respond chemotherapy, and if a negative MRI used decision use treatment strategy, timing be crucial when evaluating effect PCI. This retrospective study investigates impact outcomes staged prior chemotherapy.This included 245 diagnosed SCLC/mixed NSCLC-SCLC treated between 2012 2019. The population was analyzed separately for limited disease (LS-SCLC) extensive (ES-SCLC). Patients were divided into groups based on baseline chemotherapy primary endpoint time symptomatic BM. Secondary endpoints overall survival (OS), progression-free (PFS).In LS-SCLC probability developing at one year 4% vs. 22% (p < 0.05), median OS 55 24 months PFS 30 10 0.05) without PCI, respectively. No differences observed ES-SCLC. In multivariate regression analysis, no variables statistically significant associated risk ES-SCLC MRI, PS (HR = 3.33, CI; 1.41-7.89, p poor survival.This found that had lower incidence improved suggesting as standard care. Similar benefit not found.