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Prophylactic Cranial Irradiation (PCI)

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The Abramson Cancer Center of the University of Pennsylvania
Last Modified: May 8, 2013

Question

My doctor is suggesting I have radiation to my brain to prevent cancer from going there. Is that standard practice? Should I be concerned about the effects on my brain's function?

Answer

Charles B. Simone, II, MD, Radiation Oncologist at Penn Medicine, responds:

Radiation therapy to the brain when there is no known brain cancer there is often performed for patients with small cell lung cancer. This is termed "prophylactic cranial irradiation" and has been shown to decrease the chances of patients developing future brain metastasis and improve their overall survival, provided patients have cancer that is well controlled elsewhere, including the chest. For non-small cell lung cancer, prophylactic irradiation is much less commonly done. It can decrease the future brain metastasis risk, but its impact on survival is still not fully known, and many studies have not shown a survival benefit with this prophylactic treatment. There has been little research into the effect of this treatment on brain function long term, but it overall appears to be a safe treatment with benefits in small cell lung cancer that generally far outweigh the risks. Short-term memory loss is the most commonly observed late neurologic toxicity following prophylactic cranial irradiation, but this is often mild, particularly if the brain irradiation is delivered after chemotherapy is completed, and not at the same time as chemotherapy.

This question and answer was part of the OncoLink Brown Bag Chat Series. View the entire Focus on Lung Cancer transcript.