Does receipt of chemoimmunotherapy for LS-SCLC impact your recommendation for PCI?
Answer from: Radiation Oncologist at Academic Institution
Historic data showed that the addition of PCI for patients with limited-stage small cell lung cancer showing response after chemoradiotherapy improves overall survival and decreases brain failure rates by about 50%. Recently, the addition of consolidation immunotherapy after concurrent chemoradiothe...
Comments
Medical Oncologist at NYU Winthrop Hospital PCI has significant morbidity: cognitive dysfuncti...
Radiation Oncologist at Cleveland Clinic I have had the privilege of treating and following...
Radiation Oncologist at Quillen VA Medical Center I’ve been treating (and following) small cel...
Radiation Oncologist at Spectrum Medical Group PCI comes at the high cost of patients' quality of...
Answer from: Radiation Oncologist at Academic Institution
As someone who dislikes whole brain and would very much like to see it disappear in my career, I would agree that the standard of care currently for limited SCLC would be to offer PCI, even in the setting of the ADRIATIC trial where one could potentially speculate that there may be some intracranial...
Answer from: Radiation Oncologist at Community Practice
PCI continues to be studied despite advocacy for omission in most cases, waiting for CNS relapse. There has been advocacy for hippocampal sparing or the use of drugs to prevent neurocognitive events attributed to PCI. In my view, there are clear cases to *not* use: poor ps, over 70, and those at low...
Answer from: Radiation Oncologist at Community Practice
Neurocognitive toxicities associated with PCI are often misattributed and, unfortunately, exaggerated by SRS enthusiasts. They are generally "treatment-related" and confounded by chemotherapy (or ethanol, as Dr. @Turrisi eludes). So, it's unclear whether PCI is a primary culprit for cognitive d...
PCI has significant morbidity: cognitive dysfuncti...
I have had the privilege of treating and following...
I’ve been treating (and following) small cel...
PCI comes at the high cost of patients' quality of...