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The following is a summary of “Prophylactic cranial irradiation improved the prognosis in pT1-2N0M0 small cell lung cancers after complete resection: a retrospective real-world study,” published in the February 2025 issue of BMC Cancer by Yang et al.

The role of prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC) with the pT1-2N0M0 disease following complete resection remains a subject of debate. Previous studies have struggled to determine its potential benefit in this specific subgroup, likely due to the limited number of cases and variations in treatment approaches. This study aims to clarify the potential clinical impact of PCI in these patients. A retrospective analysis was conducted on 112 patients with SCLC with pT1-2N0M0 disease who underwent complete resection followed by adjuvant chemotherapy between January 2013 and January 2022. 

Survival outcomes and Cox regression analyses were utilized to assess the prognostic significance of PCI. The median OS had not yet been reached at the time of analysis. The 2-year, 5-year, and 8-year OS rates were 93.7%, 73.2%, and 65.7%, respectively. During follow-up, BM was observed in 17.0% (19/112) of patients. PCI significantly reduced the actuarial risk of BM from 23.9% to 4.9% (log-rank p = 0.0097, HR = 0.180, 95% CI: 0.041–0.778). Furthermore, the brain metastasis-free survival (log-rank p = 0.02) and OS (log-rank p = 0.05) were significantly improved in the PCI group compared to the non-PCI group. Multivariate Cox analysis confirmed PCI as an independent prognostic factor for both BM actuarial risk (HR = 0.198, 95% CI: 0.046–0.859, p = 0.031) and BMFS (HR = 0.387, 95% CI: 0.169–0.890, p = 0.025).

Additionally, among non-PCI patients, those with T2 disease exhibited a significantly higher risk of BM compared to those with T1 disease (log-rank p = 0.016, HR = 3.345, 95% CI: 1.177–9.511), whereas this disparity was not observed in the PCI group. These findings indicate that PCI is associated with a significant reduction in BM risk and improved survival outcomes in patients with pT1-2N0M0 SCLC following complete resection and adjuvant chemotherapy, particularly among those with T2 disease.

Source: bmccancer.biomedcentral.com/articles/10.1186/s12885-025-13667-2