Abstract: Objective: To analyze the prognosis of prophylactic neck irradiation in limited stage small cell lung cancer (SCLC) patients without neck metastasis compared with non-prophylactic neck irradiation patients. Methods:We retrospec -tively reviewed the clinical records of 88patients with limited stage SCLC from February 1998 to December 2005, which were divided into two groups, the prophylactic neck irradiation group and the non-prophylactic neck irradiation group. The survival rate, recurrence rate, distant metastasis rate and neck metastasis rate were compared between the two groups.Results: The one-year survival rates were82.00% and 84.20% (P=0.785 ) in the prophylactic neck irradiation group and the non-prophylactic neck irradiation group, respectively. The 3-year survival rates were 42.86% and 52.63% (P=0.675 ). The 5-year survival rates were 26.67% and 31.42% (P=0.641 ). The 1-year recurrence rates were 9.09% and 12.50% (P=0.663 ). The 3-year recurrence rates were 39.39% and 32.00% (P=0.562 ). The 5-year recurrence rates were 61.54% and 47.62% (P=0.341 ). The 1-year distant metastasis rates were 27.08% and 25.71% (P=0.889 ). The 3-year metastasis rates were 68.18% and 57.14% (P=0.312 ). The 5-year metastasis rates were 75.00% and 70.00% (P=0.642 ). There were 3 and 5 pa-tients respectively in the prophylactic neck irradiation group and the non-prophylactic neck irradiation group with metastasis in the neck and distant organs 2 years later and all of them died from metastases to other sites. The 2-year neck metasta -sis rates were 8.33% and 18.52% (P=0.230 ), respectively, and the average survival was 25.67and 27.40months. Conclusion: Prognoses in the two groups were not affected by prophylactic neck irradiation. Survival was not significantly im -proved in limited stage SCLC patients without neck metastasis, suggesting prophylactic neck irradiation may be an unnec-essary treatment.