Small cell lung cancer (SCLC) is an aggressive disease with a poor prognosis, whereas
its metastatic capacity carries a predilection for the brain. Although prophylactic
cranial irradiation (PCI) has been used to address this problem, upcoming alternatives
might necessitate reflection of its application in SCLC treatment.The addition of
immunotherapy to treatment guidelines has provided a new strategy for the management
of brain metastases. Complementation of immunotherapy with active MRI surveillance
could potentially replace PCI and avoid irradiation-related cognitive side effects.
SCLC's molecular profile is heterogeneous, with differential response to treatment
modalities between subgroups. Investigation of these variances might be essential
to improve therapeutic outcomes in SCLC patients.The role of PCI in SCLC treatment
must be examined in light of immunotherapy. We summarize recent results, bearing SCLC
subtypes and therapeutic vulnerabilities in mind, to derive tailored treatment strategies
for SCLC patients in future settings.
