Dr. Nasser Hanna, Indiana University Health, addresses the issue of prophylactic cranial irradiation (PCI) in locally advanced NSCLC.
Have Your Practices Changed Regarding Prophylactic Cranial Irradiation for Extensive Stage SCLC Patients?
Drs. Ben Solomon, Leora Horn, & Jack West discuss whether the data highlighting cognitive deficits from whole brain radiation therapy (WBRT) for patients with brain metastases should change our recommendations for prophylactic cranial irradiation (PCI).
Why radiate a perfectly good brain? Dr. Vivek Mehta, radiation oncologist, discusses the possible role for prophylactic cranial irradiation (PCI) for extensive stage small cell lung cancer (SCLC) to decrease risk of brain metastases and improve survival.
Radiation to the brain is a component of our treatment of limited stage small cell lung cancer, even with no evidence of cancer there. Dr. Vivek Mehta, radiation oncologist, reviews why we would do such a thing.
The doctors discuss the circumstances under which small cell lung cancer patients should receive prophylactic cranial irradiation.
This is the second of two parts in the Reference Library by Dr. Gadgeel on small cell lung cancer.
Patients with Limited Stage Small Cell Lung Cancer
In my last few weeks as a GRACE guest faculty, I have been struck by the number of forum discussions that deal with brain metastases. Brain metastases are a growing problem in non-small cell lung cancer (NSCLC), as well as in multiple other cancers. Why is this? Twenty years ago, patients who developed brain metastases were usually at the end-stage of their cancer, with widely metastatic disease and few systemic treatment options. The prognosis for these patients was very poor, but not really because of the brain metastases.
I recently had the opportunity to sit down with Dr. Toni Wozniak, Moedical Oncologist and lung cancer expert at the Barbara A. Karmanos Cancer Center at Wayne State University in Detroit, MI. We covered several topics, including SCLC, the subject of this podcast. It is an audio interview but includes a few figures that are synchronized with the audio on the video version, or you can download the pdf of the figures and just follow along with the audio.
Prophylactic cranial irradiation, or PCI, for SCLC, usually limited disease (LD-SCLC), remains a controversial issue, although this is generally recommended for patients with LD-SCLC who have a complete response to treatment (no evidence of disease). However, the idea of radiating the brain of someone who has no evidence of cancer there and may never get it is something that many patients and also some oncologists (radiation oncologists and medical oncologists) may not embrace.