To evaluate the clinical efficacy of prophylactic cranial irradiation (PCI) in the treatment of surgically resected small cell lung cancer (SCLC).

Clinical data of SCLC patients undergoing radical resection surgery in Zhejiang Cancer Hospital from 2003 to 2015 were retrospectively analyzed. According to the treatment modality, all patients were allocated into the PCI and non-PCI groups. A total of 52 patients were finally included, including 19 patients in the PCI group (5 cases of stage Ⅰ, 5 stage Ⅱ and 9 stage Ⅲ) and 33 in the non-PCI group (12 cases of stage Ⅰ, 5 stage Ⅱ and 16 stage Ⅲ). Kaplan-Meier method was utilized for survival analysis. Cox proportional hazards model was adopted to analyze clinical prognosis.

The median survival time was 32.9 months in the PCI group, and 20.4 months in the non-PCI group. The 2-year overall survival rate was 72% in the PCI group, significantly higher than 38% in the non-PCI group (P=0.023). The median brain metastasis-free survival (BMFS) was 32.5 months in the PCI group, and 17.1 months in the non-PCI group. In the PCI group, the 2-year BMFS rate was 89%, significantly better than 53% in the non-PCI group (P=0.026). Subgroup analysis demonstrated that PCI could confer survival benefit to patients with p-stage Ⅲ(P=0.031) rather than p-stage Ⅰ(P=0.924) and Ⅱ(P=0.094) counterparts. Multivariate analysis revealed that PCI (HR=0.330, P=0.041) was an independent prognostic factor of the overall survival.

PCI can reduce thr risk of brain metastasis rate and improve the overall survival of patients with surgically resected SCLC.

Carcinoma, small cell lung/surgery; Brain, neoplasms metastasis/prophylactic cranial irradiation; Prognosis