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Radiation Oncology • Thoracic Malignancies
How do you decide whether to offer PCI in patients with ES-SCLC who cannot get brain MRIs?
Knowing the OS benefit with the Slotman data in patients who did not have upfront MRIs, and the fact that the Takahashi data would not apply in his case.
In regards to offering PCI (negative upfront CT with contrast and no neurologic symptoms; very good response to chemo)?
Answer from: Radiation Oncologist at Community Practice
The Slotman study that showed a benefit for PCI did not have CNS staging (CT or MRI) done routinely for asymptomatic patients, so I don’t think of it as PCI. Since 30% or so patients with SCLC have brain metastases, this version of “PCI” is just treating brain mets. That’s pr...
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Answer from: Radiation Oncologist at Academic Institution
Normally for my ES-SCLC patients, I do discuss the Slotman trial, but generally recommend against PCI based on the Takahashi trial if they can get regular MRIs.However, I believe there is a difference in detection rates between CT and MRI, including evaluation of how big for something to actually sh...