How do you manage multiple brain metastases from small cell lung cancer?

In general, I think WBRT is a reasonable treatment for small-cell lung cancer (SCLC) brain metastases. That being said, our institution has considered SRS for select patients depending on a variety of factors as the treatment paradigm for this is evolving. There have been some studies addressing SRS...

In our precedent study to FIRE-SCLC that looked at SRS salvage following WBRT and SRS alone (Cifarelli et al., PMID 31599324), we reported a median number of mets treated as 2 with an IQR:[1-5].

"On univariate analysis, the only factor significantly associated with distant brain control was number o...

Distant failure for SRS vs WBRT for some defined number of brain mets in SCLC may not be the sole appropriate goal. Endpoints should include duration of functional independence, harm from re-treatment with SRS salvage for the SRS and WBRT arm (not common), harm from WBRT including worsening fatigue,...

Personal and institution experience.