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Extensive-stage small-cell lung cancer — SCE Respiratory MCQ

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ModerateLung CancerExtensive-stage small-cell lung cancerSCE Respiratory

A 63-year-old man with extensive-stage small-cell lung cancer has completed platinum-etoposide chemotherapy with good response. Brain MRI is negative and he remains performance status 1. He asks about reducing brain metastasis risk. What is the most appropriate management discussion?

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Correct answer: B — Discuss prophylactic cranial irradiation versus MRI surveillance in oncology clinic

In SCLC responders, brain metastasis prevention is an oncology discussion balancing prophylactic cranial irradiation and MRI surveillance, especially in extensive-stage disease. Lobectomy is not a routine strategy for extensive-stage SCLC. EGFR inhibitors and antibiotics do not reduce SCLC brain relapse risk.

Reference: NICE NG122; ESMO SCLC Guideline