Distribution of Brain Metastases in Relation to the Hippocampus: Implications for Neurocognitive Functional Preservation

Ghia, Amol J.; Thomas, S.R.; Cannon, George M.; Khuntia, Deepak; Kuo, John S.; Mehta, Minesh P.

doi:10.1016/j.ijrobp.2007.02.016

Cited by 175 publications

(144 citation statements)

References 42 publications

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…1 Since the publication of Radiation Therapy Oncology Group (RTOG) 0933 demonstrated improved memory preservation and quality of life compared with historical controls and studies showed no increased probability of metastases in the perihippocampal brain, interest in reducing dose to the hippocampi has increased. [2][3][4] Although much of the research into hippocampal sparing has focused on whole brain radiation therapy (WBRT), it is a natural progression to evaluate the role of hippocampal sparing in stereotactic radiosurgery (SRS) when treating patients with a limited number of brain metastases. The group of patients in whom SRS is usually considered would be expected to have a significantly better prognosis than patients requiring WBRT and would thus be expected to garner an increased and prolonged cognitive and quality of life benefit from hippocampal sparing.…”

Section: Introductionmentioning

confidence: 99%

Hippocampal-sparing and target volume coverage in treating 3 to 10 brain metastases: A comparison of Gamma Knife, single-isocenter VMAT, CyberKnife, and TomoTherapy stereotactic radiosurgery

Zhang

Antone

et al. 2017

Practical Radiation Oncology

View full text Add to dashboard Cite

Section: Introductionmentioning

confidence: 99%

Hippocampal-sparing and target volume coverage in treating 3 to 10 brain metastases: A comparison of Gamma Knife, single-isocenter VMAT, CyberKnife, and TomoTherapy stereotactic radiosurgery

Zhang

Antone

et al. 2017

Practical Radiation Oncology

View full text Add to dashboard Cite

“…Hence the sparing of the hippocampi may be considered safe as far as local recurrences are concerned [21]. Studies have shown that doses as low as even less than 10 Gy can cause neurocognitive dysfunction [22].…”

Section: Hippocampal Avoidance Radiation (Hart)mentioning

confidence: 99%

Emerging Role of Neurocognitive Sparing Radiotherapy: Can it be the New Standard of Care?

Mitra¹,

Kataria²

2017

J Neurol Neurophysiol

View full text Add to dashboard Cite

Whole-brain radiation therapy has been the standard form of treatment for advanced cancers, metastatic to the brain. It has the advantage of easy availability and delivery, and effectiveness in offering relief from symptoms for many suitable patients. Since most of these patients have poor outcomes and limited survival, oncologists in the past had a nihilistic approach and as a result, the potential toxicities emerging from WBRT have been largely neglected. With advances been made in neurosurgery, imaging, medical and radiation oncology, the results for many patients have improved significantly, particularly for those having favorable prognostic factors. Hence, the use of WBRT has come under scrutiny, due to its potential effect on the neurocognitive functions of the patient and their quality of life. This review article attempts to investigate if the various Neurocognitive sparing radiotherapy procedures can become a standard radiotherapy method for selected patients receiving whole brain radiotherapy for metastatic disease.

show abstract

“…[14] Consequently, it is hypothesized that conformal hippocampal avoidance during the course of WBRT (HA-WBRT) might lead to significant preservation in terms of cognitive function. [18][19][20][21] This prospective cohort study aims to explore and evaluate the impact of the delivery of HA-WBRT on the extent of NCF changes in patients receiving prophylactic or therapeutic WBRT. As compared with previous related studies, it will also be investigated whether neurocognitive functional preservation would be achieved via the integration of hippocampal sparing with the course of WBRT.…”

Section: What This Study Adds To the Fieldmentioning

confidence: 99%

“…[23,34] Indeed, it has been documented that WBRT is associated with late neurotoxicity resulting from brain irradiation and will induce multi-faceted difficulties in patients including memory, attention, and motor control; [8,35] therefore, HA-WBRT was developed to preserve cortical NCFs even after cranial RT. [20,23,36] Although quite a few researches [23,34,37,38] have conceptually hypothesized that HA-WBRT might mitigate the cognitive decline after brain RT, studies concerning the dynamic changes of NCF before and after HA-WBRT are still limited and preliminary. [39] For example, Gondi et al have conducted a Phase II clinical trial, RTOG 0933, to investigate the effects of HA-WBRT in patients with brain metastases and they evaluated memory performances by using the Hopkins Verbal Learning Test (HVLT) at 4 months after initiating brain RT.…”

Section: Neurocognitive Status/change Before and After Ha-wbrtmentioning

confidence: 99%

Evaluating the impact of hippocampal sparing during whole brain radiotherapy on neurocognitive functions: A preliminary report of a prospective phase II study

Lin¹,

Yang²,

Wu³

et al. 2015

Biomed J

View full text Add to dashboard Cite

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. Before the HA-WBRT course, all participants should receive baseline neurocognitive assessment, including memory, executive functions, and psychomotor speed. The primary endpoint was delayed recall, as determined by the change/decline in verbal memory [Wechsler Memory Scale -3 rd edition (WMS III)-Word List score] from the baseline assessment to 4 months after the start of HA-WBRT. Results:Only three patients belonged to the clinical setting of PCI; the remaining 22 patients had oligometastatic brain disease. Regarding neurocognitive outcomes, no statistically significant differences were found between various NCF scores obtained at baseline and at post-radiotherapy intervals, in immediate verbal memory and non-verbal memory, except for delayed recall memory on Word List (F = 5.727, p = 0.048). Conclusions: Functional preservation by hippocampal sparing during WBRT could largely be achieved in this study, which also suggests that HA-WBRT should be a feasible technique preserving neurocognitive functions while maintaining intracranial control. (Biomed J 2015;38:439-449) Key words: brain metastasis, hippocampus, hippocampus avoidance during whole brain radiotherapy, neurocognitive function, whole brain radiotherapy

show abstract

Distribution of Brain Metastases in Relation to the Hippocampus: Implications for Neurocognitive Functional Preservation

Cited by 175 publications

References 42 publications

Hippocampal-sparing and target volume coverage in treating 3 to 10 brain metastases: A comparison of Gamma Knife, single-isocenter VMAT, CyberKnife, and TomoTherapy stereotactic radiosurgery

Hippocampal-sparing and target volume coverage in treating 3 to 10 brain metastases: A comparison of Gamma Knife, single-isocenter VMAT, CyberKnife, and TomoTherapy stereotactic radiosurgery

Emerging Role of Neurocognitive Sparing Radiotherapy: Can it be the New Standard of Care?

Evaluating the impact of hippocampal sparing during whole brain radiotherapy on neurocognitive functions: A preliminary report of a prospective phase II study

Contact Info

Product

Resources

About