# Takahashi trial: prophylactic cranial irradiation with MRI surveillance in extensive-stage small-cell lung cancer

Source: https://onco.cc/trials/takahashi-pci/  
OnCo record `takahashi-pci` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

When patients were checked with brain MRI first, prophylactic brain irradiation no longer lengthened survival in extensive-stage small-cell lung cancer, so many centres now offer MRI surveillance instead.

## Summary

This Japanese trial randomised 224 patients with extensive-stage small-cell lung cancer, MRI-confirmed free of brain metastases after chemotherapy, to prophylactic cranial irradiation (25 Gy in ten fractions) or observation with regular MRI. Median overall survival was 11.6 months with irradiation and 13.7 months with observation (hazard ratio 1.27, not significant); brain metastases were fewer with irradiation but were caught early on surveillance and treated (Takahashi and colleagues, Lancet Oncology 2017). The trial stopped early for futility.

## Fields

- Kind: Trial
- Status: negative
- Last checked: 2026-09-17
- Tags: radiation-wave4
- Phase: 3
- Setting: Extensive-stage small-cell lung cancer with no brain metastases on MRI after chemotherapy: prophylactic cranial irradiation versus MRI surveillance
- Sponsor: West Japan Oncology Group
- Enrolled: 224
- Result: Median overall survival 11.6 (PCI) vs 13.7 months (MRI surveillance), no benefit.

## Sources

- Lancet Oncology 2017: https://doi.org/10.1016/S1470-2045(17)30230-9

## Connected records

- cancers: [Small-cell lung cancer](https://onco.cc/cancers/sclc/)
- technologies: [MRI](https://onco.cc/technologies/mri/), [Prophylactic cranial irradiation vs MRI surveillance](https://onco.cc/technologies/prophylactic-cranial-irradiation/)
- terms: [Whole-brain radiotherapy (WBRT)](https://onco.cc/terms/wbrt/)

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JSON: https://onco.cc/api/v1/entities/takahashi-pci.json