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Hippocampus radiotherapy

Petr Pospisil, Tomas Kazda, Ludmila Hynkova, Martin Bulik, Marie Dobiaskova, Petr Burkon, Nadia N Laack, Pavel Slampa, Radim Jancalek
BACKGROUND AND PURPOSE: The aim of this prospective study is to evaluate post-whole brain radiotherapy (WBRT) changes in hippocampal concentration of N-acetylaspartate (h-tNAA) as a marker of neuronal loss and to correlate those changes to neurocognitive function. MATERIAL AND METHODS: Thirty-five patients with brain metastases underwent baseline single slice multi-voxel MR spectroscopy (MRS) examination for measurement of hippocampal h-tNAA together with baseline battery of neurocognitive tests focused on memory (Auditory Verbal Learning Test and Brief Visuospatial Memory Test - Revised) as well as quality of life questionnaires (EORTC QLQ-C30 a EORTC QLQ-BN20)...
January 4, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
K Woods, R Karunamuni, A Tran, V Yu, D Nguyen, J Hattangadi-Gluth, K Sheng
PURPOSE: Thinning of the cerebral cortex has been observed in patients treated with fractionated partial brain radiation therapy and may contribute to cognitive decline following treatment. The extent of this thinning is dose-dependent, and was shown comparable to that of neurodegenerative diseases such as Alzheimer's disease at one year post-therapy. This study investigates whether 4π radiotherapy can enable better sparing of the cortex and other critical structures when compared to conventional clinical IMRT plans...
June 2016: Medical Physics
X Zhang, J Penagaricano, G Narayanasamy, R Griffin, S Maraboyina, N Paudel, C Peter, S Morrill
PURPOSE: Hippocampus avoidance whole brain radiotherapy (HA-WBRT) has been shown to reduce the risk of neurocognitive dysfunction. This type of treatment has the potential of insurance company payment denial due to increased cost of intensity modulated radiotherapy (IMRT), while the accepted modality for WBRT is three-dimensional conformal radiotherapy (3DCRT). The purpose of this study is to assess HA-WBRT treatment plans using 3DCRT and multi-criteria optimization (MCO) that meets the RTOG 0933 criteria...
June 2016: Medical Physics
B Liu, J Kim
PURPOSE: To compare the dosimetry of coplanar and non-coplanar RapidArc whole brain plans for hippocampal sparing METHODS: We studied the RapidArc plans of patient with brain metastases, with the prescription of 3750 cGy in 15 fractions. The coplanar approach used a full clockwise (CW) arc and a full counterclockwise (CCW) arc, with the couch angle to be 0°. The non-coplanar approach used a full arc with a couch angle of 0°, and a partial arc with a couch angle of 90°. Treatment planning system is Eclipse Ver...
June 2016: Medical Physics
Milan T Makale, Carrie R McDonald, Jona A Hattangadi-Gluth, Santosh Kesari
Standard treatment of primary and metastatic brain tumours includes high-dose megavoltage-range radiation to the cranial vault. About half of patients survive >6 months, and many attain long-term control or cure. However, 50-90% of survivors exhibit disabling cognitive dysfunction. The radiation-associated cognitive syndrome is poorly understood and has no effective prevention or long-term treatment. Attention has primarily focused on mechanisms of disability that appear at 6 months to 1 year after radiotherapy...
January 2017: Nature Reviews. Neurology
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...
February 7, 2017: 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...
January 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...
September 8, 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)...
November 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...
April 18, 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
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