Do you recommend prophylactic cranial irradiation for ES-SCLC patients now that immunotherapy is included in the treatment schema?
If so, do you allow a period of "washout" between immunotherapy and radiation?
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Do you offer prophylactic cranial irradiation to ES-SCLC patients who receive front line immunotherapy?
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2 Answers
Mednet MemberInvited Expert
Medical Oncology · Georgetown University Hospital
Answered on · Updated on
I do not pursue PCI for most patients with extensive stage SCLC.
We know the EORTC phase III study led by Ben Slotman (NEJM 2007) showed a decrease in the cumulative risk of brain metastases that translated into a survival benefit. One of the flaws of the study was the lack of baseline and regular M...
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Mednet MemberInvited Expert
Radiation Oncology · Thomas Jefferson University Hospital
Answered on
I became much less enthusiastic about recommending PCI in such patients. Would still bring it up for discussion in younger patients with excellent performance status and "oligometastatic" extensive stage, and would be willing to deliver it if patients were interested.
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