How do you incorporate PCI into your management of patients with extensive stage SCLC?
The role of prophylactic cranial irradiation (PCI) in the modern era of brain MRI surveillance has been called into question and is the topic of the ongoing phase 3 SWOG S1827/Maverick trial of MRI surveillance +/- PCI (or hippocampal avoidance [HA]-PCI) for LS and ES-SCLC, where I serve as the prin...
I must admit, that I was never a fan of PCI in the extensive SCLC setting. With the publication of the Japanese study, I am definitely not strongly recommending PCI. I think it is good to see the patient so that we can discuss both PCI and thoracic consolidation, but I have been doing more thoracic ...
We individualize based on the extent of response and the extent of extrathoracic disease at presentation and after chemotherapy. The fact that no other intervention in the last 20 yrs has changed survival for extensive stage SCLC except for the EORTC study, despite it's design flaws (survival double...