Does omission of PCI influence your decision whether to offer consolidative thoracic radiation in ES-SCLC after chemo + immunotherapy?  

This is one of those stories that has evolved over time with our improvements in technology.EORTC 08993 (the Slotman study) demonstrated both an improvement in the rate of symptomatic brain mets at 1 yr from 40% to 15%, and an improvement in 1 yr OS from 13% to 27%. However, a huge caveat here is th...

In short, no. PCI is primarily used in extensive stage small cell lung cancer as a quality of life issue, and much less so in consideration of survival. The risk of brain metastasis in small cell, especially large masses or metastatic disease, is huge and what many forget is that brain metastasis ca...