Prophylactic Cranial Irradiation (PCI) for Small Cell Carcinoma of the Urothelium

Pregnancy Test: Women who are able to have children must have a negative urine pregnancy test to be eligible for this study. MRI/CT Scans: Within six (6) weeks before having whole brain radiation, you will have a magnetic resonance imaging (MRI) or a computed tomography (CT) scan of your brain to check if brain tumors have developed. Simulation Visit: Before the radiation therapy begins, you will have a "simulation visit" to plan for the radiation therapy. During this session, you will be fitted to a plastic mask to hold your head still during radiation. The mask is made of a material called "thermoplastic" that becomes soft when it is placed in warm water. While this plastic is soft, it will be pulled over your face to make a mold. When the plastic cools down, it will harden again and the mask will be completed. After the mask is made, a CT scan of your head will be done for treatment planning. Radiation Therapy: You will begin radiation within 1 week after the simulation visit. You will have radiation visits Monday through Friday for 3 weeks (15 total therapy visits). Each therapy session will last about 15 minutes. It will take the study staff about 10 minutes to position you on the table and put the mask on. The radiation will be given over 2-3 minutes. On the first day of each week of therapy, you will have a brain X-ray to see if the radiation is being given to the best area. Follow-Up: After the radiation therapy, you will have an MRI or a CT scan of the brain every 6 months for 1 year and then every year for 5 years to check the status of the disease. More frequent scans will be performed if your doctor thinks they are needed. You will also complete a written mental status exam with your doctor every 3-6 months for 2 years and then every year for 5 years. The exam will have a series of tests to check your memory and ability to follow instructions. The test will take about 15 minutes to complete. Length of Study: You may remain on study for as long as you are benefitting. You will be taken off study if your disease gets worse or if intolerable side effects occur. This is an investigational study. The use of radiation to check for brain tumors before they have formed is investigational. Up to 30 patients will take part in this study. All will be enrolled at MD Anderson.