Should the incorporation of thoracic RT be standard in patients with extensive stage small cell lung cancer?

The jury is really still out on the issue of whether or not to add thoracic radiation therapy to prophylactic cranial irradiation (PCI) in patients with extensive-stage small cell lung cancer. The published data cited above, Slotman et al. in Lancet last Fall 2014, indicate that there may be an overall survival beneift at 2-years when you add thoracic RT to PCI. However, this 2-year endpoint was not the primary endpoint of the trial. This benefit at 2 years was found when looking back at the dat...

I agree with @Dr. First Last. A few pertinent points: The CREST /Slotman trial was to show a benefit at one year, and that did not occur. Few survive to two years in the ED group. Opposite of what we usually expect, those that achieved a CR to chemotherapy seemed to benefit least, and those may not need TRT. That would seem to say if the chemotherapy worked well, there is benefit where it had no access, the brain, but not in the chest. The PCI was challenged by a report by Seto from Japan, at AS...