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hippocampal sparing ,cranial irradiation

K J Redmond, R K Hales, X C Zhou, M Kummerlowe, H Sair, M Duhon, L R Kleinberg, G Rosner, T Vannorsdall
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, 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)...
2015: Radiation Oncology
S Moon, D Kim, W Chung, M Yoon
PURPOSE: The hippocampus sparing during the cranial irradiation has become interesting because it may mitigate radiation-induced neurocognitive toxicity. Herein we report our preliminary study for sparing the hippocampus with and without tilling condition for patient with brain metastases. METHODS: Ten patients previously treated with whole brain were reviewed. Five patients tilted the head to around 30 degrees and others were treated without tilting. Treatment plans of linear accelerator (Linac)-based volumetric modulated arc therapy (VMAT) and intensity modulated radiotherapy (IMRT) were generated for prescription dose of 30 Gy in 15 fractions...
June 2015: Medical Physics
M B Pinkham, P Sanghera, G K Wall, B D Dawson, G A Whitfield
About 90% of patients with brain metastases have impaired neurocognitive function at diagnosis and up to two-thirds will show further declines within 2-6 months of whole brain radiotherapy. Distinguishing treatment effects from progressive disease can be challenging because the prognosis remains poor in many patients. Omitting whole brain radiotherapy after local therapy in good prognosis patients improves verbal memory at 4 months, but the effect of higher intracranial recurrence and salvage therapy rates on neurocognitive function beyond this time point is unknown...
November 2015: Clinical Oncology: a Journal of the Royal College of Radiologists
Shinn-Yn Lin, Chi-Cheng Yang, Yi-Ming Wu, Chen-Kan Tseng, Kuo-Chen Wei, Yi-Chuan Chu, Hsiang-Yao Hsieh, Tung-Ho Wu, Ping-Ching Pai, Peng-Wei Hsu, Chi-Cheng Chuang
BACKGROUND: Whole brain radiotherapy (WBRT) is the treatment of choice for patients with brain metastases. However, neurocognitive functions (NCFs) decline due to impaired hippocampal neurogenesis might occur thereafter. It is hypothesized that conformal hippocampal avoidance during the course of WBRT (HA-WBRT) might provide meaningful NCF preservation. Our study aims to demonstrate the impact of delivering HA-WBRT on NCF changes in patients receiving WBRT. METHODS: Twenty-five patients who were referred for prophylactic cranial irradiation (PCI) or treating oligometastatic brain disease were enrolled in the study...
September 2015: Biomedical Journal
Vijayananda Kundapur, Tasha Ellchuk, Shahid Ahmed, Vinai Gondi
PURPOSE: Neurocognitive impairment (NI) in patients with small cell lung cancer (SCLC) after whole brain radiation treatment (WBRT) is a significant cause of morbidity. Hippocampal avoidance (HA) during WBRT may mitigate or prevent NI in such patients. However, this has not been tested in SCLC patients. The estimated risk of metastases in the HA region (HM) in patients with SCLC at diagnosis or after WBRT is unknown. Our study aimed to determine the risk of HM in patients with SCLC and to assess correlated clinical factors...
March 15, 2015: International Journal of Radiation Oncology, Biology, Physics
Erhan Yuksek, Seda Eroz, Ahmet Yassa, Dilara Akturk, Fagan Zakirov, Funda Engin Akcam, Murat Emul
The influence of brain radiotherapy on neurocognition is a major concern. Social cognition is a mental process in the meaning of social interaction and the recognition of facial emotion is a domain of social cognition. Thus, we aimed to investigate the early effect of whole brain radiotherapy on facial emotion recognition ability. Thirteen patients with various brain tumors in the study. Beck depression and anxiety inventory and the facial emotion recognition test by using a set of photographs were performed at the beginning and post radiotherapy...
December 2015: Psychiatric Quarterly
Tomas Kazda, Radim Jancalek, Petr Pospisil, Ondrej Sevela, Tomas Prochazka, Miroslav Vrzal, Petr Burkon, Marek Slavik, Ludmila Hynkova, Pavel Slampa, Nadia N Laack
The goal of this review is to summarize the rationale for and feasibility of hippocampal sparing techniques during brain irradiation. Radiotherapy is the most effective non-surgical treatment of brain tumors and with the improvement in overall survival for these patients over the last few decades, there is an effort to minimize potential adverse effects leading to possible worsening in quality of life, especially worsening of neurocognitive function. The hippocampus and associated limbic system have long been known to be important in memory formation and pre-clinical models show loss of hippocampal stem cells with radiation as well as changes in architecture and function of mature neurons...
2014: Radiation Oncology
Vipan K Parihar, Junaid Pasha, Katherine K Tran, Brianna M Craver, Munjal M Acharya, Charles L Limoli
Cranial radiotherapy is used routinely to control the growth of primary and secondary brain tumors, but often results in serious and debilitating cognitive dysfunction. In part due to the beneficial dose depth distributions that may spare normal tissue damage, the use of protons to treat CNS and other tumor types is rapidly gaining popularity. Astronauts exposed to lower doses of protons in the space radiation environment are also at risk for developing adverse CNS complications. To explore the consequences of whole body proton irradiation, mice were subjected to 0...
March 2015: Brain Structure & Function
Henrik Hauswald, Gregor Habl, David Krug, Denise Kehle, Stephanie E Combs, Justo Lorenzo Bermejo, Jürgen Debus, Florian Sterzing
BACKGROUND: Patients with malignant melanoma may develop brain metastases during the course of the disease, requiring radiotherapeutic treatment. In patients with 1-3 brain metastases, radiosurgery has been established as a treatment option besides surgery. For patients with 4 or more brain metastases, whole brain radiotherapy is considered the standard treatment. In certain patients with brain metastases, radiation treatment using whole brain helical Tomotherapy with integrated boost and hippocampal-sparing may improve prognosis of these patients...
2013: Radiation Oncology
Saskia Harth, Yasser Abo-Madyan, Lei Zheng, Kerstin Siebenlist, Carsten Herskind, Frederik Wenz, Frank A Giordano
PURPOSE: To estimate the risk of undertreatment in hippocampal-sparing whole brain radiotherapy (HS-WBRT). METHODS: Eight hundred and fifty six metastases were contoured together with the hippocampi in cranial MRIs of 100 patients. For each metastasis, the distance to the closest hippocampus was calculated. Treatment plans for 10 patients were calculated and linear dose profiles were established. For SCLC and NSCLC, dose-response curves were created based on data from studies on prophylactic cranial irradiation, allowing estimating the risk for intracranial failure...
October 2013: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Mark G Shaw, David L Ball
Brain metastases occur in 20-40 % of lung cancer patients. The use of whole brain radiation therapy (WBRT) has been shown to ameliorate many neurological symptoms, facilitate corticosteroid reduction, enhance quality of life (QOL), and prolong survival. The acute and early delayed side effects of WBRT are generally mild and inconsequential, whereas late complications often are progressive, irreversible, and may have a profound effect on neurocognitive function and QOL. Nevertheless, WBRT remains the cornerstone for treatment of multiple brain metastases due to its efficacy and the paucity of other treatment options...
December 2013: Current Treatment Options in Oncology
G Truc, É Martin, C Mirjolet, J Chamois, A Petitfils, G Créhange
Hippocampi plays a fundamental role in immediate or long-term memory and the spatial learning. This structure is rarely involved by metastasis and their irradiation is at the origin of some impairment of the neurocognitive function. Sparing hippocampi during whole brain radiation therapy becomes possible with volumetric modulated arc therapy (VMAT) or with helical tomotherapy. The delineation of the structures should be performed after coregistration of gadolinium-enhanced T1-weighted MR-images with the planning...
October 2013: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Kristin J Redmond, E Mark Mahone, Stephanie Terezakis, Omar Ishaq, Eric Ford, Todd McNutt, Lawrence Kleinberg, Kenneth J Cohen, Moody Wharam, Alena Horska
BACKGROUND: Neurocognitive toxicity from radiation therapy (RT) for brain tumors may be related to damage to neural progenitor cells that reside in the subventricular zone and hippocampus. This prospective study examines the relationship between RT dose to neural progenitor cell niches, temporal lobes, and cerebrum and neurocognitive dysfunction following cranial irradiation. METHODS: Standardized assessments of motor speed/dexterity, verbal memory, visual perception, vocabulary, and visuospatial working memory were conducted in 19 pediatric patients receiving cranial RT and 55 controls at baseline and 6, 15, and 27 months following completion of RT...
March 2013: Neuro-oncology
Vinai Gondi, Bruce P Hermann, Minesh P Mehta, Wolfgang A Tomé
PURPOSE: To prospectively evaluate the association between hippocampal dose and long-term neurocognitive function (NCF) impairment for benign or low-grade adult brain tumors treated with fractionated stereotactic radiotherapy (FSRT). METHODS AND MATERIALS: Adult patients with benign or low-grade adult brain tumors were treated with FSRT per institutional practice. No attempt was made to spare the hippocampus. NCF testing was conducted at baseline and 18 months follow-up, on a prospective clinical trial...
February 1, 2013: International Journal of Radiation Oncology, Biology, Physics
Jue-Feng Wan, Sheng-Jian Zhang, Lu Wang, Kuai-Le Zhao
This study delineated the incidence of metastatic involvement of neural stem cell (NSC) regions and further aimed to explore the feasibility of selectively sparing the NSC compartments during whole brain radiotherapy (WBRT) and prophylactic cranial irradiation (PCI). A total of 2270 intracranial metastases in 488 patients were identified. Lesions were classified according to locations, including lesions in the NSC compartments (subventricular zone, SVZ, or hippocampus) and those in the rest of the brain/brainstem...
March 1, 2013: Journal of Radiation Research
Vesna Prokic, Nicole Wiedenmann, Franziska Fels, Marianne Schmucker, Carsten Nieder, Anca-Ligia Grosu
PURPOSE: To develop a new treatment planning strategy in patients with multiple brain metastases. The goal was to perform whole brain irradiation (WBI) with hippocampal sparing and dose escalation on multiple brain metastases. Two treatment concepts were investigated: simultaneously integrated boost (SIB) and WBI followed by stereotactic fractionated radiation therapy sequential concept (SC). METHODS AND MATERIALS: Treatment plans for both concepts were calculated for 10 patients with 2-8 brain metastases using volumetric modulated arc therapy...
January 1, 2013: International Journal of Radiation Oncology, Biology, Physics
Pierfrancesco Franco, Gianmauro Numico, Fernanda Migliaccio, Paola Catuzzo, Domenico Cante, Paola Ceroni, Piera Sciacero, Pierpaolo Carassai, Paolo Canzi, Maria Rosa La Porta, Giuseppe Girelli, Valeria Casanova Borca, Massimo Pasquino, Santi Tofani, Franca Ozzello, Umberto Ricardi
BACKGROUND: Non-sinonasal neuroendocrine carcinomas (NSNECs) of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure. METHODS: We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects...
2012: Radiation Oncology
Arjun Sahgal, Hany Soliman, David A Larson
The purpose of this report was to review the role of whole brain radiotherapy (WBRT) in the management of brain metastases. In particular, we review the role of WBRT as a prophylactic therapy, and the role of surgery and stereotactic radiousurgery (SRS) with respect to WBRT, by discussing the relevant randomized controlled trials. WBRT is associated with toxicities and this may influence the decision to use WBRT and, therefore, we review both the acute side effects of WBRT and the more serious late side effects of neurocognitive impairment and leukoencephalopathy...
2012: Progress in Neurological Surgery
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