Prophylactic Cranial Irradiation (PCI) versus Active MRI Surveillance for Small Cell Lung Cancer: The Case for Equipoise Chad G. Rusthoven, MD, Brian.

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Prophylactic Cranial Irradiation (PCI) versus Active MRI Surveillance for Small Cell Lung Cancer: The Case for Equipoise Chad G. Rusthoven, MD, Brian D. Kavanagh, MD Journal of Thoracic Oncology Volume 12, Issue 12, Pages 1746-1754 (December 2017) DOI: 10.1016/j.jtho.2017.08.016 Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions

Figure 1 Overall survival in randomized trials of prophylactic cranial irradiation in extensive-stage SCLC. EORTC, European Organization for Research and Treatment of Cancer; MRI, magnetic resonance imaging. Adapted with permission from Slotman et al.11 and Takahashi et al.12 Journal of Thoracic Oncology 2017 12, 1746-1754DOI: (10.1016/j.jtho.2017.08.016) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions

Figure 2 Tested and self-reported cognitive decline with and without prophylactic cranial irradiation (PCI). Thin vertical bars represent the 95% confidence intervals. Adapted with permission from the pooled analysis of the RTOG 0212 and 0214 trials reported by Gondi et al.57 Journal of Thoracic Oncology 2017 12, 1746-1754DOI: (10.1016/j.jtho.2017.08.016) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions

Figure 3 White matter changes on magnetic resonance imaging (MRI) in patients with lung cancer after radiation therapy to the entire brain. Analysis of 68 patients with lung cancer with brain metastases, including 37 treated with whole-brain radiation and stereotactic radiosurgery (SRS) and 31 control patients treated with SRS alone. Image review was blinded to the treatment cohort. The median and mode whole-brain radiation dose was 30 Gy over 10 fractions (range 20–37.5 Gy). Adapted with permission from Monaco et al.63 Journal of Thoracic Oncology 2017 12, 1746-1754DOI: (10.1016/j.jtho.2017.08.016) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions