How would you approach treatment of the brain in a patient with ES-SCLC found to have CSF cytology positive for malignant cells but negative MRI of the brain?

A patient with extensive small cell lung cancer that is found to have + CSF cytology cannot be cured. The therapeutic focus should be symptom control and prolonged comfort.

The treatment for ED-SCLC is systemic therapy. Commonly, that does not cross blood brain barrier.

The question of whether to tr...

To me, the question is "why did the patient get a spinal tap?" as this is not part of the standard workup for small cell lung cancer. The most likely reason is symptomatic cranial nerve complaints/findings. These should be palliated with a brief course of whole brain radiation, with special attentio...