title: The Role of Radiotherapy in the Treatment of Small-Cell Lung Cancer.
abstract: The standard therapy for limited disease small cell lung cancer (LD-SCLC) is concurrent chemoradiotherapy and prophylactic cranial irradiation (PCI) for those who achieve complete remission (CR) or good partial response (PR) with initial therapy. On the other hand, the standard therapy for extensive disease (ED-SCLC) is chemotherapy only. After the two phase III study conducted by Slotman et al., PCI with/without thoracic radiotherapy (TRT) is also recommended in the treatment of ED-SCLC. However, a Japanese phase III study failed to confirm the benefit of PCI for patients with ED-SCLC. All studies have demonstrated the effectiveness of PCI for preventing brain metastasis, but PCI seems to have a limited influence on OS. In the 2014 edition of the Guidelines for the Treatment of Lung Cancer from the Japan Lung Cancer Society (JLCS), use of PCI for patients with ED-SCLC has been changed from "recommended" to "not recommended". Appropriate selection of patients for PCI with/without TRT is very important. It is hoped that the characteristics of patients for whom PCI with/without TRT should be considered or avoided will be better defined in the future.
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.
authors.forename: Kaname
authors.initials: K
authors.lastname: Nosaki
authors.affiliation: Department of Thoracic Oncology, National Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan. nosaki.k@nk-cc.go.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Seto
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D016371:Cranial Irradiation / Q000009:adverse effects; D018572:Disease-Free Survival; D005047:Etoposide / Q000627:therapeutic use; D017408:Guidelines as Topic; D006801:Humans; D007564:Japan; D012074:Remission Induction; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D005047:Etoposide
keywords: Prophylactic cranial irradiation; Small-cell lung cancer; Thoracic radiotherapy