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When patients were checked with brain MRI first, prophylactic brain irradiation no longer lengthened survival in extensive-stage small-cell lung cancer, so many centres now offer MRI surveillance instead.
This Japanese trial randomised 224 patients with extensive-stage small-cell lung cancer, MRI-confirmed free of brain metastases after chemotherapy, to prophylactic cranial irradiation (25 Gy in ten fractions) or observation with regular MRI. Median overall survival was 11.6 months with irradiation and 13.7 months with observation (hazard ratio 1.27, not significant); brain metastases were fewer with irradiation but were caught early on surveillance and treated (Takahashi and colleagues, Lancet Oncology 2017). The trial stopped early for futility.
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.
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 Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial, Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer, MRI.
Shares Whole-brain radiotherapy (WBRT), Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer, Small-cell lung cancer.
Shares Extensive-stage small-cell lung cancer, Small-cell lung cancer.
Shares Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer, Small-cell lung cancer, Lung cancer (all types).
Shares Prophylactic cranial irradiation vs MRI surveillance, Extensive-stage small-cell lung cancer, Small-cell lung cancer.
Shares Extensive-stage small-cell lung cancer, Small-cell lung cancer.