Prophylactic cranial irradiation in small cell lung cancer: rationale, results, and recommendations.

摘要: The utility of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC) constitutes one the longest running debates oncology. Despite dozens prospective and retrospective studies decades individual experience, a consensus has been reached on only two issues: (1) when administered to all SCLC, PCI decreases likelihood developing brain metastases by about half, but (2) does not significantly prolong survival. Uncertainty persists over many critical questions, including whether, when, how administer PCI; whether identifiable subgroups benefit more tangibly from frequent severe long-term side effects are; withholding treatment until are diagnosed is clinically responsible cost effective; newer forms for should be integrated into picture. In this review, we discuss epidemiology natural history results examining efficacy PCI, data early late toxicities status alternative therapies SCLC. Based information, an approach newly suggested, recommendations future study made.