SynthesisJournal of medical imaging and radiation oncology2026
Prophylactic Cranial Irradiation Versus Active MRI Surveillance in Small Cell Lung Cancer: Systematic Review and Meta-Analysis.
Synthesis in Journal of medical imaging and radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
8 authors.
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Abstract
backgroundProphylactic cranial irradiation (PCI) has traditionally been a cornerstone of treatment in limited-stage and extensive-stage small cell lung cancer (SCLC). Recent evidence suggests that active MRI brain surveillance may result in comparable overall survival (OS) and progression-free survival (PFS). This systematic review and meta-analysis aims to compare patient outcomes between PCI and active MRI brain surveillance.
methodMedline, Embase, Cochrane Library, Scopus and Web of Science databases were searched from inception until 30th April 2025 to identify all studies comparing PCI against active MRI brain surveillance in adult SCLC patients. Risk ratios (RR) and hazard ratios (HR) were pooled and analysed using a random-effects model.
resultFourteen studies comprising 2881 patients were included. In patients with limited-stage SCLC, PCI significantly improved OS (HR 0.67, 95% CI 0.53-0.84, p < 0.01), PFS (HR 0.77, 95% CI 0.65-0.91, p < 0.01), and brain metastasis (BM) incidence (RR 0.58, 95% CI 0.45-0.76, p < 0.01). In patients with extensive-stage SCLC, PCI only significantly reduced BM risk (RR 0.49, 95% CI 0.29-0.81, p < 0.05), but was not associated with significant improvement in OS (HR 0.89, 95% CI 0.61-1.28, p = 0.52) or PFS (HR 0.90, 95% CI 0.60-1.36, p = 0.62).
conclusionWhile PCI reduces BM incidence in both limited-stage and extensive-stage SCLC, its survival benefits are confined to limited-stage SCLC. Active MRI brain surveillance may be preferred in extensive-stage disease due to comparable survival outcomes and reduced toxicity.
trial registrationCRD42024529707 [PROSPERO].
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