Radiotherapy: prophylactic cranial irradiation: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Radiotherapy: prophylactic cranial irradiation

Sample item

In which malignancy is prophylactic cranial irradiation established to reduce brain metastases in responders to initial therapy?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Small cell lung cancer

Small cell lung cancer has a high incidence of brain metastases, and PCI in patients responding to chemo-radiotherapy reduces the rate and improves survival in limited disease. The benefit in extensive disease has been questioned with MRI surveillance. The other tumours rarely spread to the brain early.

Option by option

  • A. Small cell lung cancer (correct)

    Correct. SCLC is the classic indication for PCI.

  • B. Hepatocellular carcinoma

    HCC does not require PCI.

  • C. Papillary carcinoma of the thyroid

    Papillary thyroid carcinoma seldom metastasises to brain.

  • D. Squamous cell carcinoma of the cervix

    Cervical cancer rarely metastasises to the brain.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is A, Small cell lung cancer. Small cell lung cancer has a high incidence of brain metastases, and PCI in patients responding to chemo-radiotherapy reduces the rate and improves survival in limited disease.

Why is "Hepatocellular carcinoma" not the answer?

HCC does not require PCI.

Why is "Papillary carcinoma of the thyroid" not the answer?

Papillary thyroid carcinoma seldom metastasises to brain.

Why is "Squamous cell carcinoma of the cervix" not the answer?

Cervical cancer rarely metastasises to the brain.

What concept does this question test?

It tests Radiotherapy: prophylactic cranial irradiation in Radiology. The benefit in extensive disease has been questioned with MRI surveillance. The other tumours rarely spread to the brain early.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Radiotherapy: prophylactic cranial irradiation?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.