ArticleNeuro-oncology2014
Hippocampal sparing radiotherapy for pediatric medulloblastoma: impact of treatment margins and treatment technique.
Article in Neuro-oncology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 55 citations in OpenAlex.
- Impact of substructure radiation dose on health-related quality of life in children with brain tumors: a Pediatric Proton/Photon Consortium Registry (PPCR) study.Journal of neuro-oncology · 2025Article
- Acute side effects of proton and photon radiotherapy for medulloblastoma: a retrospective national multicenter study.Journal of neuro-oncology · 2025Article
- Intensity-modulated proton therapy for hippocampal-sparing prophylactic cranial irradiation: a planning comparison with photon therapy.BMC cancer · 2025Article
- Analysis of brain necrosis and secondary cancers after proton beam therapy for pediatric intracranial tumors: a single-center retrospective study.Frontiers in oncology · 2025Article
- Brainstem Toxicity Following Proton Beam Radiation Therapy in Pediatric Brain Tumors: A Systematic Review and Meta-Analysis.Cancers · 2024Review
- Dose-dependent cranial irradiation associations with brain structures and neuropsychological outcomes in children with posterior fossa brain tumors.Brain and behavior · 2024Article
- Robustness and dosimetric verification of hippocampal-sparing craniospinal pencil beam scanning proton plans for pediatric medulloblastoma.Physics and imaging in radiation oncology · 2024Article
- Neurocognition and mean radiotherapy dose to vulnerable brain structures: new organs at risk?Radiation oncology (London, England) · 2023Article
- Patterns of failure in pediatric medulloblastoma and implications for hippocampal sparing.Cancer · 2023Article
- Experimental validation of proton physics models of Geant4 for calculating stopping power ratio.Journal of radiological protection : official journal of the Society for Radiological Protection · 2022Article
- Normal Tissue Injury Induced by Photon and Proton Therapies: Gaps and Opportunities.International journal of radiation oncology, biology, physics · 2021Review
- Dosimetric impact of range uncertainty in passive scattering proton therapy.Journal of applied clinical medical physics · 2021Article
- Article
- Residual positioning errors and uncertainties for pediatric craniospinal irradiation and the impact of image guidance.Radiation oncology (London, England) · 2020Article
- Advantages of intensity modulated proton therapy during hippocampal avoidance whole brain radiation therapy.Physics and imaging in radiation oncology · 2018Article
- A prospective evaluation of hippocampal radiation dose volume effects and memory deficits following cranial irradiation.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2017Article
- Proton Beam Therapy for Pediatric Brain Tumor.Neurologia medico-chirurgica · 2017Review
- Highly Conformal Craniospinal Radiotherapy Techniques Can Underdose the Cranial Clinical Target Volume if Leptomeningeal Extension through Skull Base Exit Foramina is not Contoured.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2017Article
- Changes in Imaging and Cognition in Juvenile Rats After Whole-Brain Irradiation.International journal of radiation oncology, biology, physics · 2016Article
- Recommendations for the referral of patients for proton-beam therapy, an Alberta Health Services report: a model for Canada?Current oncology (Toronto, Ont.) · 2014Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundWe investigated how varying the treatment margin and applying hippocampal sparing and proton therapy impact the risk of neurocognitive impairment in pediatric medulloblastoma patients compared with current standard 3D conformal radiotherapy.
methodsWe included 17 pediatric medulloblastoma patients to represent the variability in tumor location relative to the hippocampal region. Treatment plans were generated using 3D conformal radiotherapy, hippocampal sparing intensity-modulated radiotherapy, and spot-scanned proton therapy, using 3 different treatment margins for the conformal tumor boost. Neurocognitive impairment risk was estimated based on dose-response models from pediatric CNS malignancy survivors and compared among different margins and treatment techniques.
resultsMean hippocampal dose and corresponding risk of cognitive impairment were decreased with decreasing treatment margins (P < .05). The largest risk reduction, however, was seen when applying hippocampal sparing proton therapy-the estimated risk of impaired task efficiency (95% confidence interval) was 92% (66%-98%), 81% (51%-95%), and 50% (30%-70%) for 3D conformal radiotherapy, intensity-modulated radiotherapy, and proton therapy, respectively, for the smallest boost margin and 98% (78%-100%), 90% (60%-98%), and 70% (39%-90%) if boosting the whole posterior fossa. Also, the distance between the closest point of the planning target volume and the center of the hippocampus can be used to predict mean hippocampal dose for a given treatment technique.
conclusionsWe estimate a considerable clinical benefit of hippocampal sparing radiotherapy. In choosing treatment margins, the tradeoff between margin size and risk of neurocognitive impairment quantified here should be considered.
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