Stereotactic radiosurgery optimization with hippocampal-sparing in patients treated for brain metastases
Autor: | Shawn Malone, Laura Burgess, Vimoj Nair, Lynn Chang, Julie Gratton, J. Doody |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Quality of life
lcsh:Medical physics. Medical radiology. Nuclear medicine medicine.medical_treatment lcsh:R895-920 Hippocampus Hippocampal formation lcsh:RC254-282 Radiosurgery 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Cranial Irradiation parasitic diseases medicine Radiology Nuclear Medicine and imaging In patient Hippocampal-sparing Original Research Article Stereotactic radiosurgery Radiation Equivalent dose business.industry Neurocognitive sequelae Brain metastases lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens Stereotactic radiation 030220 oncology & carcinogenesis Nuclear medicine business Neurocognitive |
Zdroj: | Physics and Imaging in Radiation Oncology, Vol 17, Iss, Pp 106-110 (2021) Physics and Imaging in Radiation Oncology |
ISSN: | 2405-6316 |
Popis: | Background and purpose Cranial irradiation is associated with significant neurocognitive sequelae, secondary to radiation-induced damage to hippocampal cells. It has been shown that hippocampal-sparing (HS) leads to modest benefit in neurocognitive function in patients with brain metastases, but further improvement is possible. We hypothesized that improved benefits could be seen using HS in patients treated with stereotactic radiation (HS-SRS). Our study evaluated whether the hippocampal dose could be significantly reduced in the treatment of brain metastases using SRS, while maintaining target coverage. Materials and methods Sixty SRS plans were re-planned to minimize dose to the hippocampus while maintaining target coverage. Patients with metastases within 5 mm of the hippocampus were excluded. Minimum, mean, maximum and dose to 40% (mean equivalent dose in 2 Gy per fraction, EQD2 to the hippocampus) were compared between SRS and HS-SRS plans. Median number of brain metastases was two. Results Compared to baseline SRS plans, hippocampal-sparing plans demonstrated Dmin was reduced by 35%, from 0.4 Gy to 0.3 Gy (p-value 0.02). Similarly, Dmax was reduced by 55%, from 8.2 Gy to 3.6 Gy, Dmean by 52%, from 1.6 Gy to 0.5 Gy, and D40 by 50%, from 1.8 Gy to 0.9 Gy (p-values Conclusions Our study demonstrated that further reduction of hippocampal doses of more than 50% is possible in the treatment of brain metastases with SRS using dose optimization. This could result in significantly improved neurocognitive outcomes for patients treated for brain metastases. |
Databáze: | OpenAIRE |
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