| KAZDA, Tomáš, Miroslav VRZAL, Tomas PROCHAZKA, Petr DVORACEK, Petr BURKOŇ, Petr POSPÍŠIL, Adam DZIACKY, T. NIKL, Radim JANČÁLEK, Pavel ŠLAMPA and Radek LAKOMÝ. Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study. Biomedical Papers, Olomouc: Palacky University. Olomouc: Palacky University, 2017, vol. 161, No 4, p. 397-402. ISSN 1213-8118. Available from: https://dx.doi.org/10.5507/bp.2017.031. |
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@article{1398899,
author = {Kazda, Tomáš and Vrzal, Miroslav and Prochazka, Tomas and Dvoracek, Petr and Burkoň, Petr and Pospíšil, Petr and Dziacky, Adam and Nikl, T. and Jančálek, Radim and Šlampa, Pavel and Lakomý, Radek},
article_location = {Olomouc},
article_number = {4},
doi = {http://dx.doi.org/10.5507/bp.2017.031},
keywords = {brain metastases; hippocampus; memory; cognition; HA WBRT},
language = {eng},
issn = {1213-8118},
journal = {Biomedical Papers, Olomouc: Palacky University},
title = {Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study},
volume = {161},
year = {2017}
}
TY - JOUR
ID - 1398899
AU - Kazda, Tomáš - Vrzal, Miroslav - Prochazka, Tomas - Dvoracek, Petr - Burkoň, Petr - Pospíšil, Petr - Dziacky, Adam - Nikl, T. - Jančálek, Radim - Šlampa, Pavel - Lakomý, Radek
PY - 2017
TI - Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study
JF - Biomedical Papers, Olomouc: Palacky University
VL - 161
IS - 4
SP - 397-402
EP - 397-402
PB - Palacky University
SN - 12138118
KW - brain metastases
KW - hippocampus
KW - memory
KW - cognition
KW - HA WBRT
N2 - 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.
ER -
KAZDA, Tomáš, Miroslav VRZAL, Tomas PROCHAZKA, Petr DVORACEK, Petr BURKOŇ, Petr POSPÍŠIL, Adam DZIACKY, T. NIKL, Radim JANČÁLEK, Pavel ŠLAMPA and Radek LAKOMÝ. Left hippocampus sparing whole brain radiotherapy (WBRT): A planning study. \textit{Biomedical Papers, Olomouc: Palacky University}. Olomouc: Palacky University, 2017, vol.~161, No~4, p.~397-402. ISSN~1213-8118. Available from: https://dx.doi.org/10.5507/bp.2017.031.
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