While we’re all very comfortable with SRS for NSCLC, there is still controversy whether SRS should be used first-line for SCLC brain metastases. This largely stems from the historic assumption that SCLC is “different.” But does intracranial SCLC really behave different from NSCLC when treated with SRS? This large retrospective study compared outcomes for NSCLC and SCLC brain mets treated with SRS. In the overall cohort, they found that the risk of CNS progression was slightly higher for SCLC and time to CNS progression was earlier. However, when SCLC patients were propensity-matched to NSCLC patients, there was no difference in CNS progression. Likewise, the risk of neurological mortality and the number of new lesions at progression were not higher with SCLC. These findings further support the use of SRS for well-selected patients with SCLC brain metastases. | Rusthoven, JNCI 2023
