In regards to Chu et al.: Patterns of brain metastasis immediately before prophylactic cranial irradiation (PCI): implications for PCI optimization in limited-stage small cell lung cancer

We read the article entitled “Patterns of brain metastasis immediately before prophylactic cranial irradiation (PCI): implications for PCI optimization in limited-stage small cell lung cancer” with great interest. In that study, the author reported about the importance of PCI timing in limited stage small cell lung cancer (LS-SCLC) in the era of MRI surveillance. In addition, the authors raise the issue of neurotoxicity of PCI. In this letter, we aimed to clarify the value of PCI in LS-SCLC and present ongoing trials regarding PCI and MRI surveillance in SCLC. As a result, we see the need for the development of a prediction tool to estimate the risk of intracranial relapse in LS-SCLC after chemoradiotherapy in order to support shared decision making through improved guidance.