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Hippocampus radiotherapy

Gwendolyn J McGinnis, David Friedman, Kristina H Young, Eileen Ruth S Torres, Charles R Thomas, Michael J Gough, Jacob Raber
BACKGROUND: Cancer patients often report behavioral and cognitive changes following cancer treatment. These effects can be seen in patients who have not yet received treatment or have received only peripheral (non-brain) irradiation. Novel treatments combining radiotherapy (RT) and immunotherapy (IT) demonstrate remarkable efficacy with respect to tumor outcomes by enhancing the proinflammatory environment in the tumor. However, a proinflammatory environment in the brain mediates cognitive impairments in other neurological disorders and may affect brain function in cancer patients receiving these novel treatments...
November 24, 2016: Oncotarget
Soon Keat Cheah, Thomas Matthews, Bin Sing Teh
BACKGROUND: Whole brain radiotherapy (WBRT) and stereotactic radiosurgery were frequently used to palliate patients with brain metastases. It remains controversial which modality or combination of therapy is superior especially in the setting of limited number of brain metastases. The availability of newer medical therapy that improves survival highlighted the importance of reducing long term radiation toxicity associated with WBRT. In this study, we aim to demonstrate the hippocampal sparing technique with whole brain and integrated simultaneous boost Materials and Methods: Planning data from 10 patients with 1-5 brain metastases treated with SRS were identified...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
Damodar Pokhrel, Sumit Sood, Christopher McClinton, Xinglei Shen, Christopher Lominska, Habeeb Saleh, Rajeev Badkul, Hongyu Jiang, Melissa Mitchell, Fen Wang
PURPOSE: To retrospectively evaluate the accuracy, plan quality and efficiency of intensity-modulated arc therapy (IMAT) for hippocampal sparing whole-brain radiotherapy (HS-WBRT) with simultaneous integrated boost (SIB) in patients with multiple brain metastases (m-BM). MATERIALS AND METHODS: A total of 5 patients with m-BM were retrospectively replanned for HS-WBRT with SIB using IMAT treatment planning. The hippocampus was contoured on diagnostic T1-weighted magnetic resonance imaging (MRI) which had been fused with the planning CT image set...
September 27, 2016: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Jan Hofmaier, Steffi Kantz, Matthias Söhn, Oliver S Dohm, Stefan Bächle, Markus Alber, Katia Parodi, Claus Belka, Maximilian Niyazi
BACKGROUND: The purpose of this study is to investigate the potential to reduce exposure of the contralateral hippocampus in radiotherapy for glioblastoma using volumetric modulated arc therapy (VMAT). METHODS: Datasets of 27 patients who had received 3D conformal radiotherapy (3D-CRT) for glioblastoma with a prescribed dose of 60Gy in fractions of 2Gy were included in this planning study. VMAT plans were optimized with the aim to reduce the dose to the contralateral hippocampus as much as possible without compromising other parameters...
2016: Radiation Oncology
Paolo Zaffino, Patrik Raudaschl, Karl Fritscher, Gregory C Sharp, Maria Francesca Spadea
PURPOSE: Multiatlas based segmentation is largely used in many clinical and research applications. Due to its good performances, it has recently been included in some commercial platforms for radiotherapy planning and surgery guidance. Anyway, to date, a software with no restrictions about the anatomical district and image modality is still missing. In this paper we introduce plastimatch mabs, an open source software that can be used with any image modality for automatic segmentation...
September 2016: Medical Physics
I Latorzeff, D Antoni, S Gaudaire-Josset, L Feuvret, A Tallet-Richard, G Truc, G Noël
Radiotherapy for brain metastases has become more multifaceted. Indeed, with the improvement of the patient's life expectancy, side effects must be undeniably avoided and the retreatments or multiple treatments are common. The cognitive side effects should be warned and the most modern techniques of radiation therapy are used regularly to reach this goal. The new classifications of patients with brain metastases help guiding treatment more appropriately. Stereotactic radiotherapy has supplanted whole brain radiation therapy both for patients with metastases in place and for those who underwent surgery...
September 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Qiongmin Ma, Donglin Wu, Ling-Li Zeng, Hui Shen, Dewen Hu, Shijun Qiu
The study aims to investigate the radiation-induced brain functional alterations in nasopharyngeal carcinoma (NPC) patients who received radiotherapy (RT) using functional magnetic resonance imaging (fMRI) and statistic scale.The fMRI data of 35 NPC patients with RT and 24 demographically matched untreated NPC patients were acquired. Montreal Cognitive Assessment (MoCA) was also measured to evaluate their global cognition performance. Multivariate pattern analysis was performed to find the significantly altered functional connections between these 2 groups, while the linear correlation level was detected between the altered functional connections and the MoCA scores...
July 2016: Medicine (Baltimore)
S Adeberg, S B Harrabi, N Bougatf, D Bernhardt, J Rieber, S A Koerber, M Syed, T Sprave, A Mohr, A Abdollahi, T Haberer, S E Combs, K Herfarth, J Debus, S Rieken
PURPOSE: The prognosis for high-grade glioma (HGG) patients is poor; thus, treatment-related side effects need to be minimized to conserve quality of life and functionality. Advanced techniques such as proton radiation therapy (PRT) and volumetric-modulated arc therapy (VMAT) may potentially further reduce the frequency and severity of radiogenic impairment. MATERIALS AND METHODS: We retrospectively assessed 12 HGG patients who had undergone postoperative intensity-modulated proton therapy (IMPT)...
June 22, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
David Vrána, Hana Študentová, Marcel Matzenauer, Zuzana Vlachová, Karel Cwiertka, David Gremlica, Ondřej Kalita
Renal cell cancer patients with brain metastatic disease generally have poor prognosis. Treatment options include surgery, radiotherapy, targeted therapy or best supportive care with respect to disease burden, patient preference and performance status. In the present case report the radiotherapy technique combining whole brain radiotherapy with hippocampal sparing (hippocampal avoidance whole brain radiotherapy HA-WBRT) and hypofractionated stereotactic radiotherapy (SRT) of the brain metastases is performed in a patient with metastatic renal cell carcinoma...
June 2016: Oncology Letters
Jun Li, Xiao-Bin Tang, Bu-Hai Wang, Xue-Mei Chen, Da Chen, Lei Chai
PURPOSE: The purpose of this study was to compare the dosimetric characteristics for protection of the hippocampus between dual arc VMAT (volumetric modulated arc therapy) and 7 fields intensity-modulated radiation therapy (7F-IMRT) for patients with brain metastases from lung cancer under the whole brain radiotherapy. METHODS: Based on ten cases with brain metastases from lung cancer, two types of radiotherapy plans were designed, namely, dual arc VMAT and 7F-IMRT...
March 17, 2016: Journal of X-ray Science and Technology
Shaefali P Rodgers, Janice A Zawaski, Iman Sahnoune, J Leigh Leasure, M Waleed Gaber
Cranial radiotherapy (CRT) increases survival in pediatric brain-tumor patients but can cause deleterious effects. This study evaluates the acute and long-term impact of CRT delivered during childhood/adolescence on the brain and body using a rodent model. Rats received CRT, either 4 Gy fractions × 5 d (fractionated) or a cumulative dose of 20 Gy (single dose) at 28 d of age. Animals were euthanized 1 d, 5 d, or 3.5 mo after CRT. The 3.5 mo group was imaged prior to euthanasia. At 3.5 mo, we observed significant growth retardation in irradiated animals, versus controls, and the effects of single dose on brain and body weights were more severe than fractionated...
2016: Neural Plasticity
Brianna M Craver, Munjal M Acharya, Barrett D Allen, Sarah N Benke, Nan W Hultgren, Janet E Baulch, Charles L Limoli
Cranial irradiation used to control CNS malignancies can also disrupt the vasculature and impair neurotransmission and cognition. Here we describe two distinct methodologies for quantifying early and late radiation injury in CNS microvasculature. Intravascular fluorescently labeled lectin was used to visualize microvessels in the brain of the irradiated mouse 2 days post exposure and RECA-1 immunostaining was similarly used to visualize microvessels in the brain of the irradiated rat 1-month post exposure. Confocal microscopy, image deconvolution and 3-dimensional rendering methods were used to define vascular structure in a ∼4 × 10(7) μm(3) defined region of the brain...
June 2016: Environmental and Molecular Mutagenesis
Sun Young Moon, Myonggeun Yoon, Mijoo Chung, Weon Kuu Chung, Dong Wook Kim
In this paper, we report the results of our investigation into whole brain radiotherapy (WBRT) using linear accelerator-based intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in lung cancer patients with a high risk of metastasis to the brain. Specifically, we assessed the absorbed dose and the rate of adverse effects for several organs at risk (OAR), including the hippocampus, according to the tilt of a patient's head. We arbitrarily selected five cases where measurements were made with the patients' heads tilted forward and five cases without such tilt...
May 2016: Physica Medica: PM
Fanny Martin, Florian Magnier, Lucie Berger, Jessica Miroir, Emmanuel Chautard, Pierre Verrelle, Michel Lapeyre, Julian Biau
BACKGROUND: Benign tumors of the skull base are a challenge when delivering radiotherapy. An appropriate choice of radiation technique may significantly improve the patient's outcomes. Our study aimed to compare the dosimetric results of fractionated stereotactic radiotherapy between non-coplanar dynamic arcs and coplanar volumetric modulated arctherapy (Rapidarc®). METHODS: Thirteen patients treated with Novalis TX® were analysed: six vestibular schwannomas, four pituitary adenomas and three meningioma...
2016: Radiation Oncology
H W C Leung, A L F Chan, M B Chang
We examined the effects of intensity-modulated radiation therapy with dose-sparing and avoidance technique on a pediatric patient with localized intracranial germinoma. We also reviewed the literature regarding modern irradiation techniques in relation to late neurocognitive sequelae. A patient with a localized intracranial germinoma in the third ventricle anterior to the pineal gland received a dose-sparing intensity-modulated radiation therapy. The planning was compared to the radiation oncologist's guide of organs at risk and dose constraints for dosimetric analyses...
May 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Marie Kalm, Ulf Andreasson, Thomas Björk-Eriksson, Henrik Zetterberg, Milos Pekny, Kaj Blennow, Marcela Pekna, Klas Blomgren
Radiotherapy in the treatment of pediatric brain tumors is often associated with debilitating late-appearing adverse effects, such as intellectual impairment. Areas in the brain harboring stem cells are particularly sensitive to irradiation (IR) and loss of these cells may contribute to cognitive deficits. It has been demonstrated that IR-induced inflammation negatively affects neural progenitor differentiation. In this study, we used mice lacking the third complement component (C3-/-) to investigate the role of complement in a mouse model of IR-induced injury to the granule cell layer (GCL) of the hippocampus...
April 12, 2016: Oncotarget
Damodar Pokhrel, Sumit Sood, Christopher Lominska, Pravesh Kumar, Rajeev Badkul, Hongyu Jiang, Fen Wang
The purpose of this study was to retrospectively investigate the accuracy, plan quality, and efficiency of using intensity-modulated arc therapy (IMAT) for whole brain radiotherapy (WBRT) patients with sparing not only the hippocampus (following RTOG 0933 compliance criteria) but also other organs at risk (OARs). A total of 10 patients previously treated with nonconformal opposed laterals whole-brain radiotherapy (NC-WBRT) were retrospectively replanned for hippocampal sparing using IMAT treatment planning...
2015: Journal of Applied Clinical Medical Physics
Bing Sun, Zhou Huang, Shikai Wu, Ge Shen, Lei Cha, Xiangying Meng, Lijuan Ding, Junliang Wang, Santai Song
PURPOSE: The safe prerequisite of hippocampal-sparing whole brain radiotherapy (HS-WBRT) for patients with breast cancer is unclear. This study investigated the risk and relapse of perihippocampal (PH) metastases in breast cancer. METHODS: Consecutive breast cancer patients with brain metastasis (BM) were reviewed. Metastases and hippocampi were contoured in cranial magnetic resonance imaging (MRI). The closest distance from metastasis to hippocampus was calculated...
January 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Ping-Fang Tsai, Chi-Cheng Yang, Chi-Cheng Chuang, Ting-Yi Huang, Yi-Ming Wu, Ping-Ching Pai, Chen-Kan Tseng, Tung-Ho Wu, Yi-Liang Shen, Shinn-Yn Lin
BACKGROUND: Whole brain radiotherapy (WBRT) has been the treatment of choice for patients with brain metastases. However, change/decline of neurocognitive functions (NCFs) resulting from impaired hippocampal neurogenesis might occur after WBRT. It is reported that conformal hippocampal sparing would provide the preservation of NCFs. Our study aims to investigate the hippocampal dosimetry and to demonstrate the correlation between hippocampal dosimetry and neurocognitive outcomes in patients receiving hippocampal sparing during WBRT (HS-WBRT)...
December 10, 2015: Radiation Oncology
C K Cramer, S W Yoon, M Reinsvold, K M Joo, H Norris, R C Hood, J D Adamson, R C Klein, D G Kirsch, M Oldham
BACKGROUND: Despite the clinical benefit of whole brain radiotherapy (WBRT), patients and physicians are concerned by the long-term impact on cognitive functioning. Many studies investigating the molecular and cellular impact of WBRT have used rodent models. However, there has not been a rodent protocol comparable to the recently reported Radiation Therapy Oncology Group (RTOG) protocol for WBRT with hippocampal avoidance (HA) which is intended to spare cognitive function. The aim of this study was to develop a hippocampal-sparing WBRT protocol in Wistar rats...
2015: PloS One
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