PREVENTIVE BRAIN IRRADIATION FOR SMALL CELL LUNG CANCER: A NEW LOOK AT THE OLD OPTION

Small cell lung cancer accounts for almost 13% of all newly diagnosed lung cancer cases. Most patients have an aggressive course of the disease, and without treatment, the average survival is from 2 to 4 months. Brain metastases are common in this disease. At the time of diagnosis, at least 18% of patients have metastases in the brain if properly examined. Preventive irradiation of the brain is now a commonly accepted part of the treatment of both localized and widespread small cell lung cancer. However, the data confirming its effectiveness is based on meta-analyses of studies conducted before the use of generally accepted and currently mandatory methods for determining the true prevalence of the disease (for example, brain MRI and PET/CT). Currently, there is increasing evidence that in modern realities, subject to careful examination and proper staging, the option of preventive brain irradiation seems to be ineffective, and modern immunotherapy can provide better cerebral control with less potential toxicity.