Application of prophylactic cranial irradiation in limited-stage small-cell lung cancer: which patients could benefit?

Aim: To analyze the role of prophylactic cranial irradiation (PCI) on the survival for patients with limited-stage small-cell lung cancer (LS-SCLC). Patients & methods: We screened patients from SEER database. Kaplan-Meier analysis and Cox proportional hazard model were used to evaluate factors influencing survival. Results: LS-SCLC patients who receiving PCI were associated with better overall survival (OS; p <0.001) and cancer-specific survival (CSS; p <0.001). Multivariable Cox analysis revealed PCI was an independent prognostic factor for OS (p<0.001) and CSS (p<0.001). In subgroup analysis, there were no OS and CSS differences between PCI and no PCI groups in black patients and patient with a tumor size <5cm (all p >0.05). Conclusion: PCI remains an effective method for most LS-SCLC patients. However, caution should be taken in recommending PCI for black patients and patients with a tumor size <5cm. Further clinical trials are necessary to validate our results and identify the most suitable patients for PCI in the modern era.