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Author Notes:

Drew Moghanaki, MD, MPH. Department of Radiation Oncology, Emory University School of Medicine, Atlanta, GA, USA. Email: drew.moghanaki@emory.edu

(I) Conception and design: JM Taylor, D Moghanaki; (II) Administrative support: D Moghanaki; (III) Provision of study materials or patients: JM Taylor; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors.

The authors would like to thank Drs. Ben Slotman and Andrew Turrisi for their thoughtful review and comments.

The series “Small Cell Lung Cancer” was commissioned by the editorial office without any funding or sponsorship. CGR reports that he is the national principle investigator of SWOG S1827/Maverick: MRI Brain Surveillance Alone versus MRI Surveillance and Prophylactic Cranial Irradiation (PCI): A Randomized Phase III Trial in Small-Cell Lung Cancer. The other authors have no other conflicts of interest to declare.

Subjects:

Research Funding:

None.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Respiratory System
  • Small cell lung cancer (SCLC)
  • prophylactic cranial irradiation (PCI)
  • MRI surveillance
  • extensive stage
  • PHASE-III TRIAL
  • WHOLE-BRAIN RADIOTHERAPY
  • RADIATION-THERAPY
  • HIPPOCAMPAL AVOIDANCE
  • COMPLETE REMISSION
  • FOLLOW-UP
  • METASTASES
  • CARCINOMA
  • RADIOSURGERY
  • MULTICENTER

Prophylactic cranial irradiation or MRI surveillance for extensive stage small cell lung cancer

Tools:

Journal Title:

JOURNAL OF THORACIC DISEASE

Volume:

Volume 12, Number 10

Publisher:

, Pages 6225-6233

Type of Work:

Article | Final Publisher PDF

Abstract:

The treatment paradigm for extensive stage small cell lung cancer (ES-SCLC) is evolving. Prophylactic cranial irradiation (PCI) has long been considered a component of standard treatment in patients with extensive stage disease who respond to chemotherapy. However, in the modern era of magnetic resonance imaging, the role of PCI has become an area of controversy following conflicting level I evidence. Due to conflicting data and toxicity concerns, the routine use of PCI has declined. Recent improvements in systemic disease control with the use of immunotherapy and reductions in the toxicity attributable to PCI with hippocampal avoidance and memantine have reignited the discussion. As such, we present here a narrative review of PCI with a focus on historical milestones, randomized data, risk mitigation and future directions.

Copyright information:

2020 Journal of Thoracic Disease. All rights reserved.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/rdf).
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