GOECP/SEOR radiotherapy guidelines for small-cell lung cancer

Table 6 Summary of the main studies of prophylactic cranial irradiation in small cell lung cancer

PCI in SCLC
Ref.	Stage (LS or ES)	Phase	Treatment	Survival	P value	Incidence of BM	P value	Level of evidence
Arriagada et al[144] 2002	LS	III	PCI; no PCI	18% at 5 yr; 15% at 5 yr	0.06	20% at 5 yr; 37% at 5 yr	< 0.001	A I
Aupérin et al[33] 1999	LS	Meta-analysis	PCI; no PCI	20.7%; 15.3%	0.01	0.38; 0.57	0.001	A I
Warde et al[20] 1992	LS	Meta-analysis	PCI; no PCI	HR 0.82		HR 0.48		A I
Takahashi et al[122] 2017	ES	III	PCI; MRI + no PCI	13.6 mo; 11.6 mo		48%; 69%		A I
Rusthoven et al[81] 2020		III	WBRT; SRS			5.2 mo; 6.5 mo	0.003	A I
Yin et al[145] 2019		Meta-analysis	PCI; observation	HR 0.81	< 0.001	HR 0.45	< 0.001	A II
De Ruysscher et al[146] 2018		III	PCI; observation	24.2 mo; 21.9 mo	0.56	7%; 27.2%	0.001	A I
Slotman et al[38] 2007	ES	III	PCI; no PCI	6.7 mo; 5.4 mo		15% at 1 yr; 40% at 1 yr	< 0.001	A I
Le Péchoux et al[154] 2009	LS	III	Standard dose PCI; high dose PCI	42%; 37%	0.05	29% at 2 yr; 23% at 2 yr	0.18	A I
Ref.	Stage (LS or ES)	Phase	Treatment	Median Survival	P value	Incidence of neurological deficit	P value	Level of evidence
Yang et al[157] 2018	LS	Meta-analysis	PCI; no PCI	HR 0.52		RR 0.5		A I
Viani et al[148] 2012	LS-ES	Meta-analysis	PCI; no PCI	OR 0.73	0.01
Ge et al[149] 2018	ES	Meta-analysis	PCI; no PCI	HR 0.57	< 0.001	RR 0.47	< 0.01	A I
Brown et al[164] 2020		III	HA + WBRT + Memantine; WBRT + Memantine			Learning 11.5%, memory 16.4%; learning 24.7%, memory 33.3%	0.049; 0.02	AI
van Meerbeeck et al[165] 2019		III	PCI; PCI + HA			HVLT-R 28%; 29%	> 0.05	A I
De Dios et al[167] 2019	LS-ES	III	PCI; PCI + HA			FCSRT 21.7%, 32.6%, and 18.5% at 3, 6 and 12 mo; FCSRT 5.1%, 7.3% and 3.8% at 3, 6 and 12 mo	< 0.05	AI

LS: Limited-stage; ES: Extensive-stage; PCI: Prophylactic cranial irradiation; SCLC: Small cell lung cancer; WBRT: Whole brain radiotherapy; SRS: Stereotactic radiosurgery; HR: Hazard ratio; RR: Relative risk; OR: Odds ratio; MRI: Magnetic resonance imaging; HA: Hippocampal avoidance; BM: Brain metastasis; HVLT-R: Hopkins Revised Verbal Learning Test; FCSRT: Free and cued selective reminding test.