Partial hippocampal sparing whole brain radiotherapy in a patient with bilateral malignant melanoma metastases to the hippocampus: a case report

McKay, Michael J.; Zadeh, Hassan Shoushtari; Sanderson, Carolyn; McKay, Thomas A.; Chindewere, Aaron

doi:10.21037/pcm-21-23

Cited by 2 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We conducted a search of the PubMed and Scopus databases between the years 1989 and 2023 using the search terms “partial hippocampal avoidance whole brain radiotherapy” OR “partial HA-WBRT”. We found only one article describing partial hippocampal sparing in a patient with BMs near both hippocampi secondary to malignant melanoma 38. The patient had lesions in the anterior aspects of both hippocampi and underwent a modified HA-WBRT protocol that irradiated the involved portions of the hippocampi with high doses and spared the uninvolved portions.…”

Section: Discussionmentioning

confidence: 99%

“…The patient had lesions in the anterior aspects of both hippocampi and underwent a modified HA-WBRT protocol that irradiated the involved portions of the hippocampi with high doses and spared the uninvolved portions. However, the authors only included the results of a 14-day follow-up and did not report the results of any formal cognitive testing 38. It was unclear from the article whether hippocampal sparing provided the desired outcome of preserving cognitive function or, furthermore, whether the patient suffered any metastatic relapse within the area of avoidance.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Partial hippocampal avoidance whole brain radiotherapy in a patient with metastatic infiltration of the left hippocampus

Leskinen,

Shah,

D' Amico

et al. 2023

BMJ Case Rep

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Partial hippocampal avoidance whole brain radiotherapy in a patient with metastatic infiltration of the left hippocampus

Leskinen,

Shah,

D' Amico

et al. 2023

BMJ Case Rep

View full text Add to dashboard Cite

“…The concept of partial hippocampal sparing in whole-brain radiation therapy (WBRT) has also been proposed by McKay et al. ( 66 ) and Sapienza et al. ( 65 ).…”

Section: Laterality In Hippocampal Functionmentioning

confidence: 99%

Unilateral hippocampal sparing during whole brain radiotherapy for multiple brain metastases: narrative and critical review

Pospisil,

Hynkova,

Hnidakova

et al. 2024

Front. Oncol.

View full text Add to dashboard Cite

BackgroundThe landscape of brain metastases radiotherapy is evolving, with a shift away from whole-brain radiotherapy (WBRT) toward targeted stereotactic approaches aimed at preserving neurocognitive functions and maintaining overall quality of life. For patients with multiple metastases, especially in cases where targeted radiotherapy is no longer feasible due to widespread dissemination, the concept of hippocampal sparing radiotherapy (HA_WBRT) gains prominence.MethodsIn this narrative review we explore the role of the hippocampi in memory formation and the implications of their postradiotherapy lateral damage. We also consider the potential advantages of selectively sparing one hippocampus during whole-brain radiotherapy (WBRT). Additionally, by systematic evaluation of relevant papers published on PubMed database over last 20 years, we provide a comprehensive overview of the various changes that can occur in the left or right hippocampus as a consequence of radiotherapy.ResultsWhile it is important to note that various neurocognitive functions are interconnected throughout the brain, we can discern certain specialized roles of the hippocampi. The left hippocampus appears to play a predominant role in verbal memory, whereas the right hippocampus is associated more with visuospatial memory. Additionally, the anterior part of the hippocampus is more involved in episodic memory and emotional processing, while the posterior part is primarily responsible for spatial memory and pattern separation. Notably, a substantial body of evidence demonstrates a significant correlation between post-radiotherapy changes in the left hippocampus and subsequent cognitive decline in patients.ConclusionIn the context of individualized palliative radiotherapy, sparing the unilateral (specifically, the left, which is dominant in most individuals) hippocampus could expand the repertoire of strategies available for adapted WBRT in cases involving multiple brain metastases where stereotactic radiotherapy is not a viable option. Prospective ongoing studies assessing various memory-sparing radiotherapy techniques will define new standard of radiotherapy care of patients with multiple brain metastases.

show abstract

Partial hippocampal sparing whole brain radiotherapy in a patient with bilateral malignant melanoma metastases to the hippocampus: a case report

Cited by 2 publications

References 11 publications

Partial hippocampal avoidance whole brain radiotherapy in a patient with metastatic infiltration of the left hippocampus

Partial hippocampal avoidance whole brain radiotherapy in a patient with metastatic infiltration of the left hippocampus

Unilateral hippocampal sparing during whole brain radiotherapy for multiple brain metastases: narrative and critical review

Contact Info

Product

Resources

About