Rates of Overall Survival and Intracranial Control in the Magnetic Resonance Imaging Era for Patients With Limited-Stage Small Cell Lung Cancer With and Without Prophylactic Cranial Irradiation

Key Points Question After staging with magnetic resonance imaging, is there a benefit associated with prophylactic cranial irradiation (PCI) for patients with limited-stage small cell lung cancer? Findings In this single-institution cohort study, a propensity-matched analysis of 297 patients was conducted. The 3-year cumulative incidence rate of brain metastases was higher in the group that did not undergo PCI vs the group that did undergo PCI, but the difference was not statistically significant; PCI was not associated with an overall survival benefit. Meaning Given the neurocognitive toxic effects associated with whole-brain radiation therapy, these data suggest that the benefits of PCI for unselected patients with limited-stage small cell lung cancer are limited.