Should Patients with Extrapulmonary Small-Cell Carcinoma Receive Prophylactic Cranial Irradiation?

Abstract

Brain metastases were uncommon in EPSCC compared with small-cell lung carcinoma. PCI is thus probably not warranted in this disease.

Controversies in small cell carcinoma of the head and neck: Prophylactic cranial irradiation (PCI) after primary complete initial remission

“…However, due the small sample size, authors did not recommend PCI routinely but advised to consider it as a treatment option in patients responding to initial therapy. In line with previous studies, PCI was not recommended in Brennan et al [7] and Naidoo et al [17] series. Brennan et al [7] presented the outcome of 120 patients with extrapulmonary SmCC, 19 with primary SmCCHN and one received PCI.…”

“…However, considering the overall lower incidence of brain metastasis (13%) and the small number of patients who received PCI, authors did not recommended it in routine clinical practice. Naidoo et al [17] collected data of 280 patients from the National Cancer Registry of Ireland. Only 12 were primary head and neck and one (8.3%) developed brain metastasis.…”

“…In all, of 1012 patients with extrapulmonary SmCC, 29 received PCI, none of whom developed brain metastasis. Of the 983 who did not have PCI, 106 (10.8%) developed brain metastasis [7,[12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] ( Table 1).…”

Current approaches for prophylactic cranial irradiation in extrapulmonary small cell carcinoma

“…Also in this study, patients with brain metastasis had a long OS, which highlighted the low rate of mortality related to brain metastasis. In conclusion, due to the low incidence of brain metastasis in this patient group the authors of this study do not recommend PCI for patients with EPSCLC 23 .…”

Extrapulmonary small cell carcinoma of lymph node: Pooled analysis of all reported cases

“…Eight studies (n = 14) were included in the current analysis ( Figure 6) [16][17][18][19][20][21][22][23] . Studies that did not provide separate information for patients with LNEPSCC [29][30][31][32][33][34][35][36][37][38][39][40][41] , and the treatment given or follow up were not included in the current review [42][43][44][45][46][47][48][49][50] . A total of 17 patients including the three index cases (mean ± SD, 59.5 ± 10.8 years; 81.8% males) with LNEPSCC were included in the current analysis (Table 1).…”