2Department of Radiation Oncology, Bağcılar Hospital, İstanbul-Türkiye
3Koç University Faculty of Medicine, İstanbul-Türkiye
4Department of Radiation Oncology, VKF American Hospital, İstanbul-Türkiye
5Department of Medical Oncology, Koç University, İstanbul-Türkiye DOI : 10.5505/tjo.2025.4722 OBJECTIVE
The survival benefit of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC) is generally based on data that do not reflect the modern era in which magnetic resonance imaging (MRI) is actively used. In this study, we aimed to investigate the cumulative incidence of brain metastasis between patient groups treated with and without PCI in a cohort where MRI was routinely used for staging and follow-up.
METHODS
A total of 73 patients with LS-SCLC who achieved a response to concurrent chemoradiotherapy (cCRT)
at our institution between March 2010 and December 2023 were retrospectively analyzed. Radiotherapy
was usually administered with dose escalation using a twice-daily schedule (54 Gy in 30 fractions). Patients
were divided into two groups according to PCI administration.
RESULTS
Among 73 patients (38 PCI, 35 non-PCI), baseline characteristics were similar between groups. The use
of first-line immunotherapy and dose-escalated twice-daily radiotherapy were significantly higher in the
non-PCI group. The cumulative incidence of central nervous system (CNS) recurrence in the entire cohort
was 26%, and it was similar between PCI and non-PCI groups (26.4% vs. 25.7%, p=0.953). However, the
time to CNS recurrence was significantly longer in patients who received PCI (28 vs. 7 months, p=0.013).
CONCLUSION
Our study indicates that PCI does not significantly reduce the cumulative incidence of metastasis in
patients with LS-SCLC but prolongs the time to metastasis.