The Headline: Overall survival was doubled with radiosurgery versus HA-WBRT for patients with SCLC with brain mets.
The Study: The phase 3 NRG-CC009 trial randomized 151 patients with small cell lung cancer (SCLC) with brain metastases to radiosurgery versus standard hippocampal-avoidance whole brain radiation (HA-WBRT) with memantine. The primary endpoint of time to neurocognitive failure was not significantly improved with radiosurgery (HR 0.83; 95% CI, 0.53–1.28; p=0.39). Intriguingly, the prespecified secondary endpoint of overall survival was significantly improved with radiosurgery (median 17.4 vs. 8.6 months; HR 0.60). Unexpectedly, there was no significant difference in time to intracranial failure or salvage therapy.
TBL: This strengthens the case for radiosurgery rather than routine WBRT for patients with SCLC with brain mets when reliable MRI follow-up is available. | Rusthoven, ASTRO 2026
The Study: The phase 3 NRG-CC009 trial randomized 151 patients with small cell lung cancer (SCLC) with brain metastases to radiosurgery versus standard hippocampal-avoidance whole brain radiation (HA-WBRT) with memantine. The primary endpoint of time to neurocognitive failure was not significantly improved with radiosurgery (HR 0.83; 95% CI, 0.53–1.28; p=0.39). Intriguingly, the prespecified secondary endpoint of overall survival was significantly improved with radiosurgery (median 17.4 vs. 8.6 months; HR 0.60). Unexpectedly, there was no significant difference in time to intracranial failure or salvage therapy.
TBL: This strengthens the case for radiosurgery rather than routine WBRT for patients with SCLC with brain mets when reliable MRI follow-up is available. | Rusthoven, ASTRO 2026