Prophylactic cranial irradiation in patients with extensive-stage small cell lung cancer

Brain metastases occur in the majority of patients with small cell lung cancer (SCLC).¹ The blood–brain barrier prevents sufficient entry of most chemotherapeutic agents into the brain,² and once brain metastases are visible radiographically, few patients remain curable. The very high prevalence of brain metastases in patients with SCLC combined with the poor intracranial penetration of most chemotherapy regimens used in the disease and the potential curability of such patients led to the development and utilization of prophylactic cranial irradiation (PCI), a preventative radiotherapeutic treatment of the entire brain targeting subclinical intracranial metastatic disease.

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