title: Prophylactic cranial irradiation in small cell lung cancer: A single institution experience.
abstract: OBJECTIVE
  To compare patient demographics, prophylactic cranial irradiation (PCI) utilization and overall survival (OS) of patients with small cell lung cancer (SCLC) referred to a large tertiary center with those reported in large clinical trials.
  
  
  METHODS
  A retrospective review was conducted of consecutive patients with limited stage (LS) and extensive stage (ES) SCLC diagnosed at the Princess Alexandra Hospital between January 2008 and December 2013.
  
  
  RESULTS
  Two hundred and three patients with a mean age of 65.4 (±10.7) years were followed for a median duration of 7.6 months (range 0.5-76.5). At diagnosis, 129 (64%) patients had ES-SCLC, including 39 (19.2%) with cerebral metastases. Median OS in LS-SCLC patients receiving PCI was 18.8 months (0.9-69.4), compared with 8.2 months (0.1-34.4) in patients who did not receive PCI (P < 0.001). Median OS in the ES-SCLC cohort receiving PCI was 13.6 months (5.2-37.5) compared to 5.6 months (0.1-73.6) in patients who did not receive the therapy (P < 0.001). There was a significant improvement in intracranial disease-free survival of 7.1 months in patients with ES-SCLC who received PCI. Forty-two LS-SCLC patients (57%) did not receive PCI due to patient suitability.
  
  
  CONCLUSIONS
  In our SCLC cohort, median OS following PCI in LS-SCLC and ES-SCLC is comparable to published data. PCI use at our institution was lower than utilization rates in large meta-analyses, predominately due to poor chemotherapy tolerance and patient suitability. This may be more representative of patients treated in clinical practice rather than those recruited into large phase III trials.
authors.affiliation: Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Luke
authors.initials: L
authors.lastname: Nicholls
authors.affiliation: Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Keir
authors.affiliation: Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Murphy
authors.affiliation: Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Tao
authors.initials: T
authors.lastname: Mai
authors.affiliation: Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Margot
authors.initials: M
authors.lastname: Lehman
mesh_terms: D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000517:prevention & control* / Q000556:secondary; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000401:mortality / Q000517:prevention & control* / Q000556:secondary; D015996:Survival Rate
keywords: prophylactic cranial irradiation; small cell lung cancer