J 2017

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

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

Basic information

Original name

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

Authors

KAZDA, Tomáš (203 Czech Republic, guarantor, belonging to the institution), Miroslav VRZAL (203 Czech Republic), Tomas PROCHAZKA (203 Czech Republic), Petr DVORACEK (203 Czech Republic), Petr BURKOŇ (203 Czech Republic, belonging to the institution), Petr POSPÍŠIL (203 Czech Republic, belonging to the institution), Adam DZIACKY (703 Slovakia, belonging to the institution), T. NIKL (203 Czech Republic), Radim JANČÁLEK (203 Czech Republic, belonging to the institution), Pavel ŠLAMPA (203 Czech Republic, belonging to the institution) and Radek LAKOMÝ (203 Czech Republic, belonging to the institution)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

20601 Medical engineering

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 1.087

RIV identification code

RIV/00216224:14110/17:00098710

Organization unit

Faculty of Medicine

DOI

UT WoS

000418005200010

Keywords in English

brain metastases; hippocampus; memory; cognition; HA WBRT

Tags

Tags

International impact, Reviewed
Změněno: 20/3/2018 14:26, Soňa Böhmová

Abstract

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.