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Slotman's trial showed that irradiating the brain before metastases appear cuts symptomatic brain metastases and lengthens survival in extensive-stage small-cell lung cancer, though a later Japanese trial with MRI screening did not confirm the survival gain.
EORTC 08993 randomised 286 patients with extensive-stage small-cell lung cancer who had responded to chemotherapy to prophylactic cranial irradiation or observation. Symptomatic brain metastases within a year fell from 40.4 to 14.6 percent and one-year survival rose from 13.3 to 27.1 percent (Slotman and colleagues, New England Journal of Medicine 2007). Patients were not required to have brain imaging before entry; Takahashi's 2017 trial with MRI surveillance found no survival benefit, so practice now varies.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
286 enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Symptomatic brain metastases within 1 yearprimary | Prophylactic cranial irradiation | 143 | 14.6% | - | - | - |
| Observation | 143 | 40.4% |
Shares Prophylactic Cranial Irradiation Overview (Auperin meta-analysis), Whole-brain radiotherapy (WBRT), Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer and the tag radiation-wave4.
Shares EORTC and the tag radiation-wave4.
Shares EORTC and the tag radiation-wave4.
Shares EORTC and the tag radiation-wave4.
Shares Whole-brain radiotherapy (WBRT), Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer, Small-cell lung cancer.
Shares Prophylactic cranial irradiation in extensive small-cell lung cancer, Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer, Small-cell lung cancer.
Shares CREST: consolidation thoracic radiotherapy in extensive-stage small-cell lung cancer, Extensive-stage small-cell lung cancer, Small-cell lung cancer, Lung cancer (all types).
Shares CREST: consolidation thoracic radiotherapy in extensive-stage small-cell lung cancer, Extensive-stage small-cell lung cancer, Small-cell lung cancer, Lung cancer (all types).