In ES-SCLC presenting with extensive brain metastases, how do you time whole brain radiation after the first cycle of chemotherapy has already been delivered?  

We typically try to wait as long as possible before we start WBRT. It depends on the burden and symptomatology of intracranial disease as well as the initial response to chemo-immunotherapy. If the brain metastases are asymptomatic and deemed OK to monitor closely (i.e., not likely to cause neurolog...