Pozonec Veronika, Pozonec Maria Dorothea, Aigner Clemens, Widder Joachim, Boettiger Kristiina, Megyesfalvi Zsolt, Dome Balazs
Department of Thoracic Surgery, Semmelweis University and National Institute of Oncology.
Multidisciplinary Centre of Head and Neck Tumors, National Institute of Oncology.
Curr Opin Oncol. 2025 Jan 1;37(1):27-34. doi: 10.1097/CCO.0000000000001111. Epub 2024 Dec 2.
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.
小细胞肺癌（SCLC）是一种侵袭性疾病，预后较差，其转移能力使其易转移至脑部。尽管预防性颅脑照射（PCI）已被用于解决这一问题，但即将出现的替代方法可能需要重新审视其在SCLC治疗中的应用。
在治疗指南中加入免疫疗法为脑转移瘤的管理提供了新策略。免疫疗法与动态磁共振成像监测相结合可能会取代PCI，并避免与照射相关的认知副作用。SCLC的分子特征具有异质性，各亚组对治疗方式的反应不同。研究这些差异对于改善SCLC患者的治疗效果可能至关重要。
必须根据免疫疗法来审视PCI在SCLC治疗中的作用。我们总结近期结果，同时考虑SCLC亚型和治疗易损性，以便在未来为SCLC患者制定量身定制的治疗策略。
