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Do you ever withhold PCI for elderly patients with limited stage SCLC?

In elderly patients (>70-75) with a good performance status, does the risk of neurocognitive decline outweigh the benefit of PCI?
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Do you recommend PCI for elderly patients with limited stage SCLC?

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4 Answers
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Radiation Oncology · University of Colorado School of Medicine
Answered on

In my opinion, the findings by Takahashi et al, Lancet 2017 regarding the lack of survival benefit of PCI as compared to MRI observation in patients with extensive SCLC has re-opened the question of the survival benefit of PCI in limited SCLC in the modern imaging era. Hopefully, a phase III study o...

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Radiation Oncology · UT MD Anderson Cancer Ctr
Answered on · Updated on

This is a great question, and one that we don't have a definitive answer for at this time. Certainly, PCI is not without its significant side effects, especially on neuro-cognition, and the early clinical trials on PCI in LS-SCLC patients showed a benefit in OS for the entire cohort, but did not str...

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Radiation Oncology · University of Colorado School of Medicine
Answered on

This is a great question that touches on potential shifts in the risk-benefit ratio of prophylactic cranial irradiation (PCI) in older patients against a backdrop of larger questions regarding the contemporary overall survival (OS) benefit of PCI in the era of brain MRI surveillance - the latter is ...

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Medical Oncology · Mary Lanning Healthcare Morrison Cancer Center/University of Nebraska Medical Center Adjunct Faculty
Answered on

This is a question that begs for the science and art of oncology. I look at the individual patient, I look at not only calendar age but functional age and comorbidities, and life expectancy. The definition of "elderly" is quite relative.

Advances in intensity-modulated radiotherapy (IMRT) and pre-tr...

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