Controversies in small cell carcinoma of the head and neck: Prophylactic cranial irradiation (PCI) after primary complete initial remission. Issue 8 (September 2015) - De Felice, Francesca
Highlights: Small cell carcinoma of head and neck region (SmCCHN) represents a rare entity. The role of prophylactic cranial irradiation (PCI) in SmCCHN is still debated. No randomized studies tested PCI value after complete response to primary treatment. This is the largest reported analysis of published data. This analysis suggests that PCI could offer improved outcomes in SmCCHN. 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.