Abstract 210P
Background
The role of prophylactic cranial irradiation (PCI) in limited-stage small cell lung cancer (LS-SCLC) in the era of magnetic resonance imaging surveillance is unclear. The aim of this study was to investigate the value of PCI in patients with LS-SCLC regarding overall survival (OS), progression-free survival (PFS) and the incidence of brain metastases.
Methods
We searched five electronic databases, including PubMed/Medline, Scopus, Clinicalkey, Embase and the Cochrane Library, from January 2013 to December 2023. We identified 6657 potential publications using the following keywords: “Small Cell Lung Cancer”, or “SCLC” and “prophylactic cranial irradiation” or “PCI”. We selected twenty-one studies with 3559 LS-SCLC patients (PCI cohort n=1832, non-PCI cohort n=1727) based on the inclusion criteria and extracted and pooled OS and PFS rate as well as brain metastasis (BM) incidence.
Results
Using a random effect model, we estimated that PCI significantly improved OS and PFS (hazard ratio (HR) = 0.614, 95% confidence interval [CI]: 0.539-0.699, P < 0.001; HR = 0.605, 95% CI: 0.459-0.797, P < 0.001, respectively). Furthermore, we found that PCI was associated with a significant reduction in the risk of BM (risk ratio (RR) = 0.638, 95% CI: 0.53–0.768, P < 0.001).
Conclusions
Our meta-analysis revealed a significant beneficial effect of PCI regarding OS, PFS and the incidence of BM in patients with LS-SCLC in the era of MRI surveillance. However, several limitations need to be considered such as inclusion of small studies, heterogenous follow-up of brain MRI and lack of randomized studies included in this meta-analysis. Several ongoing phase III randomized trials such as MAVERICK/SWOG S1827, PRIMALung/EORTC-1901 and LS-SCLC-III-PCI 2021/NCT04829708 are comparing PCI to MRI surveillance in LS-SCLC and will provide further evidence and clarify this issue.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.