Summary

Prophylactic cranial irradiation in the treatment of extensive-stage small cell lung cancer has proven value in reducing symptomatic brain metastases and in improving overall survival at 1 year. However, persistent intrathoracic disease occurs in 76% of such patients and intrathoracic disease progresses in almost 90% of this group. This article discusses data from the Chest Radiotherapy Extensive Stage Trial [CREST; NTR1527] that evaluated the use of thoracic radiotherapy in addition to PCI for treatment of ES-SCLC to prevent occurrence of thoracic disease and halt its progression.