Author of

• 32099

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  EP1.12 - Small Cell Lung Cancer/NET (ID 202)

  • Event: WCLC 2019
  • Type: E-Poster Viewing in the Exhibit Hall
  • Track: Small Cell Lung Cancer/NET
  • Presentations: 1
  • Now Available
  • Moderators:
  • Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall

  • 32100

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    EP1.12-01 - Does PCI Still Have a Role in Limited SCLC? (Now Available) (ID 2721)

    08:00 - 18:00  |  Author(s): Olga Belochitski
    • Abstract
    • Slides

    Background
    

    Prophylactic cranial irradiation (PCI) has long been an integral part of treatment protocols for limited stage small cell lung cancer (SCLC). PCI stands for "prophylactic" while it may be not really prophylactic, rather therapeutic for un-detectable brain disease.

    Method
    

    A survey of 39 questions was conducted on the online platform “Survey Monkey” for practicing oncologists, radiotherapists, pulmonologists and thoracic surgeons. The aim of this survey is to establish a practice baseline for a future multicenter study of overall survival (OS) benefits of PCI versus MRI follow-up in limited SCLC.

    Result
    

    41 respondents participated from 14 European countries (26 oncology centers) and from 4 US radiotherapy centers: medical oncologists (31%), radiation oncologist (25%), pulmonologists (34%). Brain imaging at diagnosis of SCLC is performed by MRI in 83% and CT with contrast in 49%. Brain follow up after chemotherapy is performed by MRI in 49%, CT with contract in 41%, and no imaging in asymptomatic patients in 20%. PCI is recommended to 67% of patients and performed immediately after the last chemotherapy in 37%, or 2 months after chemotherapy in 49%. The most important criteria whether patient needs PCI are performance status and response to chemotherapy. The most common schedule of PCI is 25Gy in 10 fractions, 41% of respondents. In case of a single brain metastasis after PCI the 1st choice of treatment is SRS, in 93%. Regarding the role of PCI 46% of respondents think that PCI prevents brain metastases from occurring, and 54% think that PCI treats occult brain metastases.

    Conclusion
    

    The lack of clinical trials about PCI for limited SCLC patients is undisputed. Our survey shows practice patterns to PCI for patients with limited SCLS depends on Institution and/or specialty. These results establish a practice baseline for a multicentral trial of PCI versus MRI observation, and 93% of our respondents agreed to take part in this trial.

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