SRS alone for Brain Mets from Small Cell Lung Cancer?

[Mandelin Rain]

Yes or no? What about an SRS boost after WBRT?

1 or 2 moderate sized lesions.

What if mixed histology, i.e. small/non-small cell? Does that change your thinking?

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[evilbooyaa]

Yes or no? What about an SRS boost after WBRT?

1 or 2 moderate sized lesions.

What if mixed histology, i.e. small/non-small cell? Does that change your thinking?

I have no data to support this, but I would think SRS as salvage after WBRT would be reasonable in the right patient. Given the radiosensitivity of SCLC, not sure on the utility of an SRS boost when WBRT will provide generally good brain clearance anyways. Maybe a good role for HS-WBRT?

 

[scarbrtj]

Has the patient not already previously had whole-brain as would be the standard of care for almost all limited or extensive small cell patients anyway? If previous WBRT, SRS as a first option is a... no-brainer. If hasn't previously been exposed to WBRT, probably should be (25 Gy/10 fx) in addition to SRS. WBRT is very fruitful in SCLC it seems, whereas in NSCLC it's relatively unfruitful in comparison, don't you agree...