Controversies in small cell carcinoma of the head and neck: Prophylactic cranial irradiation (PCI) after primary complete initial remission

Cancer Treat Rev. 2015 Sep;41(8):725-8. doi: 10.1016/j.ctrv.2015.05.002. Epub 2015 May 8.

Abstract

Small cell carcinoma of head and neck region (SmCCHN) represents a rare entity and its management remains a significant clinical challenge. Complete initial response to primary therapy poses a difficult and controversial scenario for radiation oncologists. Prophylactic cranial irradiation (PCI) has long been established in the management of small cell lung cancer; however, its role in SmCCHN is still called into question. The rationale behind PCI lies in the eradication of possible micro-metastatic brain disease, which is often documented in this type of cancer. No randomized trials on this topic are available. This review, based on 20 retrospective studies, addresses the controversies in the use of PCI in SmCCHN management.

Keywords: Extrapulmonary; Head and neck; Prophylactic cranial irradiation; Remission; Small cell carcinoma.

Publication types

  • Review

MeSH terms

  • Brain Neoplasms* / prevention & control
  • Brain Neoplasms* / secondary
  • Carcinoma, Small Cell* / pathology
  • Carcinoma, Small Cell* / radiotherapy
  • Cranial Irradiation / methods*
  • Head and Neck Neoplasms* / pathology
  • Head and Neck Neoplasms* / radiotherapy
  • Humans
  • Remission Induction / methods
  • Retrospective Studies
  • Treatment Outcome