Résumé
Small cell lung cancer (SCLC) has the biological characteristics of high recurrence and metastasis. The brain is the common site of SCLC extrapulmonary metastasis. Prophylactic cranial irradiation (PCI) can effectively reduce the incidence of brain metastasis and prolong the overall survival of patients with limited SCLC. Nevertheless, nearly one third of patients develop brain metastases after PCI. This article reviews the risk factors of brain metastasis after PCI, aiming to determine which subgroup of patients with limited SCLC can benefit from PCI and provide reference for the clinical application of PCI.
Résumé
Thoracic radiotherapy is a major treatment and dose fractionation remains controversial in limited-stage small cell lung cancer. Twice-daily (BID) radiotherapy, as a standard protocol established in prospective studies, is often replaced by other treatment strategies in clinical practice due to the occurrence of side effects and inconvenience. In addition, in inoperable stage Ⅰ small cell lung cancer with negative lymph nodes, stereotactic ablative radiotherapy (SABR) provides a new option for some elderly patients who are expected to be unable to tolerate long-term radiotherapy. The appropriate dose fractionation scheme can both ensure the therapeutic effects and reduce toxic effects. This article reviews the research of limited-stage small cell lung cancer about dose fractionation.