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Purpose The use of prophylactic cranial irradiation (PCI) in small cell lung cancer (SCLC) with surgery resection has not been fully identified.This study is to assess factors affecting the risk of brain metastases in patients with stage Ⅰ-Ⅲ SCLC after surgery resection.Implications of PCI treatment for these patients are discussed.Methods and Materials One hundred and twenty-six patients treated with surgical resection for stage Ⅰ-Ⅲ SCLC from Jan.1998 to Dec.2009 were retrospectively analyzed to elucidate risk factors of brain metastases.Log-Rank test and Cox-regression model were used to analyze risk factors of brain metastases.Results Median survival time for this patient population was 34 months, and the 5-year overall survival rate was34.9%.For the whole group, 23.0% (29/126) patients had evidence of metastases to brain.Pathology stage was not only correlated with overall survival but also significantly affected the risk of brain metastases.The 5-year survival rates for patients with pathology stage Ⅰ, Ⅱ and Ⅲ were54.8%、 35.6% and 14.1%, respectively (p=0.001).The frequency of brain metastases in patients with pathological stage Ⅰ, Ⅱ and Ⅲ were 6.25% (2/32), 28.2% (11/39) and 29.1% (16/55) (P=0.026),respectively.A significant difference in brain metastases between patients with complete resection and incomplete resection was also observed (20.5% vs 42.9%, P=0.028).Frequency of brain metastases was not found to be correlated with age, sex, pathological type, induction chemotherapy,adjuvant chemotherapy, and adjuvant radiotherapy.Concluions Stage Ⅰ SCLC patients with complete resection had a low incidence of brain metastases and favorable survival rate.Stage Ⅱ-Ⅲdisease had a higher incidence of brain metastases.Thus PCI might have a role for stage Ⅱ-Ⅲdisease but not for stage Ⅰ disease.