J 2017

Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study

KAZDA, Tomáš; Miroslav VRZAL; Tomas PROCHAZKA; Petr DVORACEK; Petr BURKOŇ et. al.

Základní údaje

Originální název

Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study

Autoři

KAZDA, Tomáš; Miroslav VRZAL; Tomas PROCHAZKA; Petr DVORACEK; Petr BURKOŇ; Petr POSPÍŠIL; Adam DZIACKY; T. NIKL; Radim JANČÁLEK; Pavel ŠLAMPA ORCID a Radek LAKOMÝ

Vydání

Biomedical Papers, Olomouc: Palacky University, Olomouc, Palacky University, 2017, 1213-8118

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

20601 Medical engineering

Stát vydavatele

Česká republika

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 1.087

Kód RIV

RIV/00216224:14110/17:00098710

Organizační jednotka

Lékařská fakulta

UT WoS

000418005200010

EID Scopus

2-s2.0-85038371482

Klíčová slova anglicky

brain metastases; hippocampus; memory; cognition; HA WBRT

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 20. 3. 2018 14:26, Soňa Böhmová

Anotace

V originále

Aims. Unilateral sparing of the dominant (left) hippocampus during whole brain radiotherapy (WBRT) could mitigate cognitive decline, especially verbal memory, similar to the widely investigated bilateral hippocampus avoidance (HA-WBRT). The aim of this planning study is dosimetrical comparison of HA-WBRT with only left hippocampus sparing (LHA-WBRT) plans. Methods. HA-WBRT plans for 10 patients were prepared in accordance with RTOG 0933 trial and served as baseline for comparisons with several LHA-WBRT plans prepared with an effort: 1) to maintain the same left hippocampus dosimetry ("BEST PTV") and 2) to maintain same dosimetry in planning target volume as in HA-WBRT ("BEST LH"). Results. All HA-WBRT plans met RTOG 0933 protocol criteria with a mean Conformity index 1.09 and mean Homogeneity index (HI) 0.21. Mean right and left hippocampal D100% was 7.8 Gy and 8.5 Gy and mean Dmax 14.0 Gy and 13.8 Gy, respectively. "BEST PTV" plans reduced HI by 31.2% (P=0.005) which is mirrored by lower PTV_D2% (-0.8 Gy, P=0.005) and higher PTV_D98% (+1.3 Gy, P=0.005) as well as decreased optic pathway's Dmax by 1 Gy. In "BEST LH", mean D100% and Dmax for the left hippocampus were significantly reduced by 11.2% (P=0.005) and 10.9% (P=0.005) respectively. Conclusions. LHA-WBRT could improve target coverage and/or further decrease in dose to spared hippocampus. Future clinical trials must confirm whether statistically significant reduction in left hippocampal dose is also clinically significant.