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Pooling 987 patients from seven trials showed that irradiating the brain of people whose small-cell lung cancer had gone into remission, before any brain secondaries appeared, made them live longer.
Aupérin, Arriagada, Pignon, Le Péchoux and the Prophylactic Cranial Irradiation Overview Collaborative Group analysed individual data on 987 patients with small-cell lung cancer in complete remission from seven trials comparing prophylactic cranial irradiation with none. Survival was the main endpoint.
It is one of the few interventions in oncology that treats an organ with no detectable disease in it and extends life, and the principle it established, that micrometastatic sanctuary sites can be treated pre-emptively, is the direct ancestor of the brain metastasis prevention question that next-generation ALK and EGFR inhibitors now raise.
Treating the brain before the cancer gets there works in small-cell lung cancer, and it is the proof of principle behind every later attempt to prevent rather than treat brain metastases.
One trial page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
The standard of care in limited-stage small-cell lung cancer from 1999 until ADRIATIC added immunotherapy in 2024, and a rare example of a curative gain in a disease that has had almost none.
Shares Twice-daily compared with once-daily thoracic radiotherapy in limited small-cell lung cancer treated concurrently with cisplatin and etoposide, Prophylactic cranial irradiation vs MRI surveillance, Limited-stage small-cell lung cancer, Radiotherapy and the tag lung-evidence.
Shares Measure brain metastasis prevention as a primary endpoint, not as a secondary one, Prevention trials aimed only at brain metastasis, Brain metastases (intracranial disease), The brain: barrier and sanctuary and the tag lung-evidence.
Shares Measure brain metastasis prevention as a primary endpoint, not as a secondary one, Brain metastases (intracranial disease), Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Dormant cells and minimal residual disease and the tag lung-evidence.
Shares Measure brain metastasis prevention as a primary endpoint, not as a secondary one, Brain metastases (intracranial disease), The brain: barrier and sanctuary, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch and the tag lung-evidence.
Shares Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Extensive-stage small-cell lung cancer, Toxicity and quality of life are undervalued, New England Journal of Medicine and the tag lung-evidence.
Shares Brain metastases (intracranial disease), Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Toxicity and quality of life are undervalued, New England Journal of Medicine and the tag lung-evidence.
Shares Limited-stage small-cell lung cancer, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Extensive-stage small-cell lung cancer, Lung cancer (all types) and the tag lung-evidence.
Shares Prophylactic cranial irradiation vs MRI surveillance, Lung cancer roadmap: from Doll and Hill and the naming of tobacco, through the cytotoxic plateau, computed tomography screening, EGFR and ALK, immunotherapy by PD-L1, the perioperative trials and PACIFIC, to DLL3 in small-cell disease and a 2032 registry watch, Extensive-stage small-cell lung cancer, Lung cancer (all types) and the tag lung-evidence.