Small cell lung cancer intracranial metastases treatment

Small cell lung cancer intracranial metastases treatment: Surgical resection considered for inmediate life-threating large lesions.

XRT is used otherwise.

The standard treatment of clinically evident brain metastases is whole brain radiotherapy (WBRT), usually in combination with corticosteroids and the solitary metastasis might be additional irradiated with stereotactic radiotherapy or Gamma Knife ¹⁾ ²⁾ ³⁾ ⁴⁾.

Prophylactic cranial irradiation did not result in longer overall survival compared with observation in patients with extensive-disease small-cell lung cancer. Prophylactic cranial irradiation is therefore not essential for patients with extensive-disease small-cell lung cancer with any response to initial chemotherapy and a confirmed absence of brain metastases when patients receive periodic MRI examination during follow-up ⁵⁾.

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Strojan P. Role of radiotherapy in melanoma management. Radiol Oncol. 2010;44:1–12.

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Park HS, Chiang VL, Knisely JP, Raldow AC, Yu JB. Stereotactic radiosurgery with or without whole-brain radiotherapy for brain metastases: an update. Expert Rev Anticancer Ther. 2011;11:1731–8.

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Tran TA, Wu V, Malhotra H, Steinman JP, Prasad D, Podgorsak MB. Target and peripheral dose from radiation sector motions accompanying couch repositioning of patient coordinates with the Gamma Knife® Perfexion™ Radiol Oncol. 2011;45:132–142.

⁴⁾

Quan AL, Videtic GM, Suh JH. Brain metastases in small cell lung cancer. Oncology (Williston Park). 2004 Jul;18(8):961-72; discussion 974, 979-80, 987. Review. PubMed PMID: 15328892.

⁵⁾

Takahashi T, Yamanaka T, Seto T, Harada H, Nokihara H, Saka H, Nishio M, Kaneda H, Takayama K, Ishimoto O, Takeda K, Yoshioka H, Tachihara M, Sakai H, Goto K, Yamamoto N. Prophylactic cranial irradiation versus observation in patients with extensive-disease small-cell lung cancer: a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2017 May;18(5):663-671. doi: 10.1016/S1470-2045(17)30230-9. Epub 2017 Mar 23. PubMed PMID: 28343976.