Prophylactic cranial irradiation improves survival rate of patients with small-cell lung cancer in complete remission

Small-cell lung cancer accounts for 20-25% of lung cancer. Treatment with chemotherapy and thoracic radiotherapy yields complete response rates of 50-85%. But, due to relapses, only 15% of patients who achieved complete response survived at 3 years since treatment. Tumour spread to brain (metastasis) is one of the main types of relapse, occurring in more than 50% of patients. Several clinical trials showed that prophylactic cranial irradiation (X-ray treatment of the brain for preventing brain metastasis) halves the rate of brain metastasis but they did not show whether this treatment can help people to live longer. This review found that prophylactic cranial irradiation given to patients in complete remission after initial treatment improves survival. At 3 years since treatment 20.7% of patients who received prophylactic cranial irradiation survived, compared to 15.3% for those who did not received this irradiation. Prophylactic cranial irradiation should now be considered part of the standard treatment of patients with small-cell lung cancer in complete remission.