Prophylactic cranial irradiation or no prophylactic cranial irradiation in metastatic small cell lung cancer: is it a relevant question once again?

Even if chemotherapy is the cornerstone treatment of small cell lung cancer (SCLC), this disease has a particular propensity to recur locally and disseminate in the brain. Hence, there have been several randomized trials assessing the role of thoracic and brain radiotherapy (1). Two individual patient data-based meta-analyses showed that thoracic radiotherapy and prophylactic cranial irradiation (PCI) should be part of the therapeutic strategy (2,3).