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hippocampal sparing ,cranial irradiation

Terence T Sio, Anussara Prayongrat, Yun Zhang, Qin Lin, Ting Xu, Zhongxing Liao, Jinbo Yue
New randomized data from Japan have raised questions regarding the use of prophylactic cranial irradiation for patients with extensive-stage small-cell lung cancer but without detectable brain metastases on magnetic resonance imaging. In the present focused review, we examine the general role of prophylactic cranial irradiation in the management of small-cell lung cancer and present relevant controversies from both sides of the discussion. Future directions for clinical investigation and research are also highlighted...
March 16, 2018: Clinical Lung Cancer
Benjamin H Lok, Jennifer Ma, Amanda Foster, Carmen A Perez, Weiji Shi, Zhigang Zhang, Bob T Li, Charles M Rudin, Andreas Rimner, Abraham J Wu
Purpose: Brain metastases are common in patients with limited-stage small cell lung cancer (LS-SCLC) due to the inability of most chemotherapeutics to penetrate the blood-brain barrier. Prophylactic cranial irradiation (PCI) is therefore recommended for use in patients with a good response to concurrent chemoradiotherapy. However, PCI is not always delivered; therefore, we investigated the reasons for PCI omission in patients who underwent therapy with curative intent. Methods and materials: We retrospectively reviewed all patients with LS-SCLC who were treated with curative intent at our institution...
October 2017: Advances in Radiation Oncology
Ting Martin Ma, Jimm Grimm, Riley McIntyre, Heather Anderson-Keightly, Lawrence R Kleinberg, Russell K Hales, Joseph Moore, Tracy Vannorsdall, Kristin J Redmond
BACKGROUND AND PURPOSE: To prospectively evaluate hippocampal radiation dose volume effects and memory decline following cranial irradiation. MATERIAL AND METHODS: Effects of hippocampal radiation over a wide range of doses were investigated by combining data from three prospective studies. In one, adults with small cell lung cancer received hippocampal-avoidance prophylactic cranial irradiation. In the other two, adults with glioblastoma multiforme received neural progenitor cell sparing radiation or no sparing with extra dose delivered to subventricular zone...
November 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Sumit Sood, Damodar Pokhrel, Christopher McClinton, Christopher Lominska, Rajeev Badkul, Hongyu Jiang, Fen Wang
A prospective clinical trial, Radiation Therapy Oncology Group (RTOG) 0933, has demonstrated that whole brain radiotherapy (WBRT) using conformal radiation delivery technique with hippocampal avoidance is associated with less memory complications. Further sparing of other organs at risk (OARs) including the scalp, ear canals, cochleae, and parotid glands could be associated with reductions in additional toxicities for patients treated with WBRT. We investigated the feasibility of WBRT using volumetric-modulated arc therapy (VMAT) to spare the hippocampi and the aforementioned OARs...
August 16, 2017: Medical Dosimetry: Official Journal of the American Association of Medical Dosimetrists
Lei Zhao, Yan Shen, Jin-Dong Guo, Heng-Le Gu, Wen Yu, Jia-Ming Wang, Chang-Xing Lv, Jun Liu, Xu-Wei Cai, Xiao-Long Fu
BACKGROUND: This work aims to assess the feasibility of selectively sparing the hippocampus during prophylactic cranial irradiation (PCI) for small cell lung cancer (SCLC). METHODS: SCLC patients with brain metastases (BMs) diagnosed with MRI were enrolled. Lesions localized to the neural stem cell (NSC) compartments [subventricular zone (SVZ) or hippocampus] were analyzed. Patients were categorized by the total number of intracranial metastases, the therapy processes and the symptoms...
July 15, 2017: Radiation Oncology
Kristin J Redmond, Russell K Hales, Heather Anderson-Keightly, Xian C Zhou, Megan Kummerlowe, Haris I Sair, Mario Duhon, Lawrence Kleinberg, Gary L Rosner, Tracy Vannorsdall
PURPOSE: To prospectively evaluate cognitive function and intracranial failure patterns after hippocampal-sparing prophylactic cranial irradiation (PCI) for limited-stage small cell lung cancer (SCLC). METHODS AND MATERIALS: Adults with limited-stage SCLC, achieving a complete response to chemoradiotherapy and no brain metastases, were eligible. Patients received PCI 25 Gy/10 fractions, with a mean hippocampal dose limited to <8 Gy and ≥90% of the brain receiving 90% of the prescription...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Saide Di Biase, Marianna Trignani, Luciana Caravatta, Paul Ioan Voicu, Clelia Di Carlo, Annamaria Vinciguerra, Antonietta Augurio, Francesca Perrotti, Valentina Panara, Domenico Genovesi
BACKGROUNDS: Irradiation of the hippocampus plays a role in neurocognitive toxicity. Its delineation is complex and in practice different head position can vary hippocampus morphology on axial images; so atlas in a single standard position can result ineffective to describe different hippocampal morphologies in different head set-up. The purpose of our study was to develop a guide based on magnetic resonance imaging for hippocampus delineation in three different head set-ups. MATERIALS AND METHODS: Three patients were selected to elaborate our guide...
September 2017: La Radiologia Medica
Ren Zhao, Wei Kong, Jun Shang, Hong Zhe, Yan-Yang Wang
Brain metastases occur in 20% to 40% of lung cancer patients. Whole-brain radiotherapy (WBRT) has long been considered the treatment of choice for many patients with lung cancer, because of its wide availability, ease of delivery, and effectiveness in prolonging survival. However, WBRT is also associated with several side effects, such as decline in memory and other cognitive functions. There exists significant preclinical and clinical evidence that radiation-induced injury to the hippocampus correlates with neurocognitive decline of patients who receive WBRT...
March 2017: Clinical Lung Cancer
Fabian Bartel, Hugo Vrenken, Fetsje Bijma, Frederik Barkhof, Marcel van Herk, Jan C de Munck
PURPOSE: Precise and reproducible hippocampus outlining is important to quantify hippocampal atrophy caused by neurodegenerative diseases and to spare the hippocampus in whole brain radiation therapy when performing prophylactic cranial irradiation or treating brain metastases. This study aimed to quantify systematic differences between methods by comparing regional volume and outline reproducibility of manual, FSL-FIRST and FreeSurfer hippocampus segmentations. MATERIALS AND METHODS: This study used a dataset from ADNI (Alzheimer's Disease Neuroimaging Initiative), including 20 healthy controls, 40 patients with mild cognitive impairment (MCI), and 20 patients with Alzheimer's disease (AD)...
2017: PloS One
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)...
December 10, 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
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