Hippocampal dosimetry correlates with the change in neurocognitive function after hippocampal sparing during whole brain radiotherapy: a prospective study
| Autor: | Chi-Cheng Chuang, Chen-Kan Tseng, Yi-Liang Shen, Shinn-Yn Lin, Chi-Cheng Yang, Yi-Ming Wu, Ting-Yi Huang, Ping-Fang Tsai, Ping-Ching Pai, Tung-Ho Wu |
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| Jazyk: | angličtina |
| Předmět: |
Oncology
medicine.medical_specialty medicine.medical_treatment Hippocampal formation Neuropsychological Tests Hippocampal dosimetry Hippocampus Cognition Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Medical physics Prospective Studies Radiation treatment planning Prospective cohort study Radiation Injuries Radiometry business.industry Brain Neoplasms Research Radiotherapy Planning Computer-Assisted Wechsler Adult Intelligence Scale Executive functions Radiation therapy Radiology Nuclear Medicine and imaging Brain metastasis Whole brain radiotherapy Neurocognitive functions Hippocampus Hippocampus sparing during whole brain radiotherapy Radiotherapy Intensity-Modulated Verbal memory Cranial Irradiation business Neurocognitive |
| Zdroj: | Radiation Oncology (London, England) |
| ISSN: | 1748-717X |
| DOI: | 10.1186/s13014-015-0562-x |
| Popis: | 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). Methods Forty prospectively recruited cancer patients underwent HS-WBRT for therapeutic or prophylactic purposes. Before receiving HS-WBRT, all participants received a battery of baseline neurocognitive assessment, including memory, executive functions and psychomotor speed. The follow-up neurocognitive assessment at 4 months after HS-WBRT was also performed. For the delivery of HS-WBRT, Volumetric Modulated Arc Therapy (VMAT) with two full arcs and two non-coplanar partial arcs was employed. For each treatment planning, dose volume histograms were generated for left hippocampus, right hippocampus, and the composite hippocampal structure respectively. Biologically equivalent doses in 2-Gy fractions (EQD2) assuming an alpha/beta ratio of 2 Gy were computed. To perform analyses addressing the correlation between hippocampal dosimetry and the change in scores of NCFs, pre- and post-HS-WBRT neurocognitive assessments were available in 24 patients in this study. Results Scores of NCFs were quite stable before and after HS-WBRT in terms of hippocampus-dependent memory. Regarding verbal memory, the corresponding EQD2 values of 0, 10, 50, 80 % irradiating the composite hippocampal structure with |
| Databáze: | OpenAIRE |
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