Outcome of prophylactic cranial radiotherapy in extensive-stage small cell lung cancer: The christie experience over two years

Objective: Prophylactic cranial irradiation (PCI) in extensive‐stage small cell lung cancer does not only reduce the risk of developing brain metastases (BM) but also prolongs disease‐free and overall survival [1]. We adopted this treatment as standard in patients who responded to chemotherapy, PS 0‐2 and age ≤75 years. We present the outcome data of patients treated in our institution over a period of 2 years. Methods: We reviewed the casenotes of all patients treated with PCI between January 2007 and December 2008. Patients did not routinely undergo imaging of the brain prior to receiving PCI or chemotherapy if there was no clinical suspicion of BM. The median follow up was 14 months. Results: There were 51 patients in total (25 males and 26 females). The median age was 63 yrs (43‐75). Prior to radiotherapy 29 patients had documented WHO performance (PS) status 0‐1, 14 patients had PS 2, 1 had PS 3 and in 6 cases the PS was not documented. Patients received either 4 (= 15), 5 (n=5) or 6 (n=31) cycles of cisplatin or carboplatin and etoposide chemotherapy. Al patients responded to chemotherapy (at least stable disease). Al patients received 20 Gy in 5 daily fractions of whole brain prophylactic cranial radiotherapy. 13 patients (25%) developed BM. The survival figures are shown in table 1. (Table presented). Conclusion: Using the same inclusion criteria as described in the Slotman study the rates of BM (and survival) after PCI were in keeping with the published data in our institution. It is encouraging that the results of the randomised controlled trial are applicable to a standard population.