EORTC 08993 (Slotman): prophylactic cranial irradiation in extensive-stage small-cell lung cancer
Slotman's trial showed that irradiating the brain before metastases appear cuts symptomatic brain metastases and lengthens survival in extensive-stage small-cell lung cancer, though a later Japanese trial with MRI screening did not confirm the survival gain.
Overview
EORTC 08993 randomised 286 patients with extensive-stage small-cell lung cancer who had responded to chemotherapy to prophylactic cranial irradiation or observation. Symptomatic brain metastases within a year fell from 40.4 to 14.6 percent and one-year survival rose from 13.3 to 27.1 percent (Slotman and colleagues, New England Journal of Medicine 2007). Patients were not required to have brain imaging before entry; Takahashi's 2017 trial with MRI surveillance found no survival benefit, so practice now varies.
- 14.6 vs 40.4 out of 100 reached this endpoint with Prophylactic cranial irradiation compared with Observation; 25.8 fewer per 100.
- On this measure the first group did worse, not better.
- This endpoint is not one of the standard survival or response measures; read it alongside the trial's primary result.
- These results apply to the people the trial enrolled: Extensive-stage small-cell lung cancer responding to chemotherapy: prophylactic cranial irradiation versus observation. People in a different situation may not see the same effect.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
286 participants enrolled.
| Endpoint | Arm | n | Value | HR (95% CI) | p | Source |
|---|---|---|---|---|---|---|
| Symptomatic brain metastases within 1 yearprimary | Prophylactic cranial irradiation | 143 | 14.6% | - | - | - |
| Observation | 143 | 40.4% |
Similar pages
not linked directly; found by shared links- TrialTakahashi trial: prophylactic cranial irradiation with MRI surveillance in extensive-stage small-cell lung cancer
Shares Whole-brain radiotherapy (WBRT), Prophylactic cranial irradiation vs MRI surveillance, Small-cell lung cancer and the tag radiation-wave4.
- TermProphylactic cranial irradiation (PCI)
Shares Whole-brain radiotherapy (WBRT), Prophylactic cranial irradiation vs MRI surveillance, Small-cell lung cancer.
- IdeaMRI surveillance replaces prophylactic cranial irradiation in SCLC
Shares Prophylactic cranial irradiation vs MRI surveillance, Small-cell lung cancer.
- TrialADRIATIC
Shares Prophylactic cranial irradiation vs MRI surveillance, Small-cell lung cancer.
- TermLimited-stage vs extensive-stage (small-cell lung cancer)
Shares Prophylactic cranial irradiation vs MRI surveillance, Small-cell lung cancer.
- PathwayThe blood-brain barrier & brain metastasis
Shares Prophylactic cranial irradiation vs MRI surveillance, Small-cell lung cancer.