{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:10:28Z","timestamp":1789564228379,"version":"build-2803163510"},"reference-count":36,"publisher":"Harborside Press, LLC","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Prophylactic cranial irradiation (PCI) reduces the incidence of brain metastases (BMs) in patients with limited-stage small cell lung cancer (LS-SCLC). However, predictive biomarkers that identify patients most likely to benefit from PCI have not been established. This study investigates the potential of\n                    <jats:sup>18<\/jats:sup>\n                    F-fluoro-2-deoxyglucose (\n                    <jats:sup>18<\/jats:sup>\n                    F-FDG) PET as a predictor of PCI benefit in patients with LS-SCLC.\n                    <jats:bold>Patients and Methods:<\/jats:bold>\n                    This multicenter study analyzed patients with LS-SCLC who underwent brain MRI and\n                    <jats:sup>18<\/jats:sup>\n                    F-FDG PET\/CT at baseline, followed by treatment with concurrent chemoradiotherapy. To evaluate whether the benefit of PCI varies according to BM risk, we compared outcomes between PCI-treated and untreated patients stratified by risk group.\n                    <jats:bold>Results:<\/jats:bold>\n                    Of 261 patients overall, 171 received PCI and 90 did not. In patients not receiving PCI, high metabolic tumor volume (MTV; &gt;45.201 cm\n                    <jats:sup>3<\/jats:sup>\n                    ) was associated with inferior intracranial time to progression (iTTP; hazard ratio [HR], 5.62; 95% CI, 1.69\u201318.77;\n                    <jats:italic>P<\/jats:italic>\n                    =.005), progression-free survival (PFS; HR, 2.35; 95% CI, 1.38\u20134.02;\n                    <jats:italic>P<\/jats:italic>\n                    =.002), and overall survival (OS; HR, 2.23; 95% CI, 1.27\u20133.91;\n                    <jats:italic>P<\/jats:italic>\n                    =.005). Conversely, MTV demonstrated no significant association with survival outcomes among PCI recipients. Subgroup analysis revealed that PCI conferred no survival advantage in the low-MTV group, whereas in the high-MTV group, PCI was associated with improved iTTP (HR, 0.27; 95% CI, 0.15\u20130.51;\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.001), PFS (HR, 0.49; 95% CI, 0.35\u20130.69;\n                    <jats:italic>P<\/jats:italic>\n                    &lt;.001), and OS (HR, 0.56; 95% CI, 0.40\u20130.80;\n                    <jats:italic>P<\/jats:italic>\n                    =.001). Interaction analysis confirmed a significant effect modification between MTV status and PCI benefit for iTTP, PFS, and OS, supporting MTV as an independent predictive biomarker for PCI benefit.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Baseline PET-derived MTV serves as a clinically relevant predictor of PCI benefit in LS-SCLC, supporting a risk-adapted PCI strategy guided by metabolic imaging biomarkers. This approach may reduce unnecessary neurotoxicity and optimize treatment outcomes and should be prospectively validated.\n                  <\/jats:p>","DOI":"10.6004\/jnccn.2026.7029","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T12:56:17Z","timestamp":1786625777000},"source":"Crossref","is-referenced-by-count":0,"title":["Metabolic Tumor Volume as a Predictor of Benefit From Prophylactic Cranial Irradiation in Limited-Stage Small Cell Lung Cancer"],"prefix":"10.6004","volume":"24","author":[{"given":"Taejun","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Gon","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Hwan","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seoyoung","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moonki","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae-Hoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Sup","family":"Shim","sequence":"additional","affiliation":[{"name":"Department of Pathology, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangwoo","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Biomedical Systems Informatics and Brain Korea 21 PLUS Project for Medical Science, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Kyoung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Medical Records, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min Hee","family":"Hong","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ja Hyun","family":"Yeo","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong In","family":"Yoon","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Yonsei Cancer Center, Heavy Ion Therapy Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye Ryun","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4047","reference":[{"key":"B1","series-title":"Nat Rev Dis Primers","first-page":"3","article-title":"Small-cell lung cancer","volume":"7","author":"Rudin CM","year":"2021","unstructured":"Rudin CM, Brambilla E, Faivre-Finn C, Sage J. 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N Engl J Med 1999;341:476\u2013484."},{"key":"B22","series-title":"J Natl Cancer Inst","first-page":"183","article-title":"Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission","volume":"87","author":"Arriagada R","year":"1995","unstructured":"Arriagada R, Le Chevalier T, Borie F,  Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. J Natl Cancer Inst 1995;87:183\u2013190."},{"key":"B23","series-title":"EClinicalMedicine","first-page":"102396","article-title":"Re-examining prophylactic cranial irradiation in small cell lung cancer: a systematic review and meta-analysis","volume":"67","author":"Gaebe K","year":"2024","unstructured":"Gaebe K, Erickson AW, Li AY,  Re-examining prophylactic cranial irradiation in small cell lung cancer: a systematic review and meta-analysis. 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Quant Imaging Med Surg 2023;13:8545\u20138556."},{"key":"B36","series-title":"J Radiat Oncol","first-page":"191","article-title":"Metabolic tumor volume on PET reduced more than gross tumor volume on CT during radiotherapy in patients with non-small cell lung cancer treated with 3DCRT or SBRT","volume":"2","author":"Mahasittiwat P","year":"2013","unstructured":"Mahasittiwat P, Yuan S, Xie C,  Metabolic tumor volume on PET reduced more than gross tumor volume on CT during radiotherapy in patients with non-small cell lung cancer treated with 3DCRT or SBRT. 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