ArticleStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2015
Whole brain irradiation with hippocampal sparing and dose escalation on multiple brain metastases: Local tumour control and survival.
Article in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 2 of them syntheses that pooled it.
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Who cites it
43 citing papers in PubMed, 2 syntheses or guidelines pooled it, 73 citations in OpenAlex.
- Efficacy and safety evaluation of combined therapies incorporating whole-brain radiotherapy in patients with brain metastases: a systematic review and meta-analysis.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2024Pooled it
- Whole brain radiotherapy for the treatment of newly diagnosed multiple brain metastases.The Cochrane database of systematic reviews · 2018Pooled it
- Simultaneous stereotactic radiosurgery of multiple brain metastases using single-isocenter dynamic conformal arc therapy: a prospective monocentric registry trial.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Trial
- Single Pontine Relapse Shortly After Hippocampal Avoidance Whole Brain Radiotherapy: A Case Report.Cancer reports (Hoboken, N.J.) · 2025Article
- [The role of whole brain irradiation nowadays: more or less or different?]Magyar onkologia · 2024Article
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- Neurotoxicity-sparing radiotherapy for brain metastases in breast cancer: a narrative review.Frontiers in oncology · 2023Review
- Frequency of metastases within the hypothalamic-pituitary area and the associated high-risk factors in patients with brain metastases.Frontiers in neurology · 2023Article
- Optimization of hippocampus sparing during whole brain radiation therapy with simultaneous integrated boost-tutorial and efficacy of complete directional hippocampal blocking.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Article
- Role of modern radiotherapy in managing patients with hepatocellular carcinoma.World journal of gastroenterology · 2021Review
- Radiotherapy of brain metastasis from lung cancer in limited resource settings.Journal of thoracic disease · 2021Review
- Brain metastases of lung cancer: comparison of survival outcomes among whole brain radiotherapy, whole brain radiotherapy with consecutive boost, and simultaneous integrated boost.Journal of cancer research and clinical oncology · 2021Article
- Hippocampus-Avoidance Whole-Brain Radiation Therapy Is Efficient in the Long-Term Preservation of Hippocampal Volume.Frontiers in oncology · 2021Article
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- Sparing the hippocampus and the hypothalamic- pituitary region during whole brain radiotherapy: a volumetric modulated arc therapy planning study.BMC cancer · 2020Article
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- Early experience with hippocampal avoidance whole brain radiation therapy and simultaneous integrated boost for brain metastases.Journal of neuro-oncology · 2020Article
- Early volume reduction of the hippocampus after whole-brain radiation therapy: an automated brain structure segmentation study.Japanese journal of radiology · 2020Article
- Brain Metastases From Lung Adenocarcinoma May Preferentially Involve the Distal Middle Cerebral Artery Territory and Cerebellum.Frontiers in oncology · 2020Article
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Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHippocampal-avoidance whole brain radiotherapy (HA-WBRT) for multiple brain metastases may prevent treatment-related cognitive decline, compared to standard WBRT. Additionally, simultaneous integrated boost (SIB) on individual metastases may further improve the outcome. Here, we present initial data concerning local tumour control (LTC), intracranial progression-free survival (PFS), overall survival (OS), toxicity and safety for this new irradiation technique. METHODS AND MATERIALS: Twenty patients, enrolled between 2011 and 2013, were treated with HA-WBRT (30 Gy in 12 fractions, D98% to hippocampus ≤ 9 Gy) and a SIB (51 Gy) on multiple (2-13) metastases using a volumetric modulated arc therapy (VMAT) approach based on 2-4 arcs. Metastases were evaluated bidimensionally along the two largest diameters in contrast-enhanced three-dimensional T1-weighed MRI.
resultsMedian follow-up was 40 weeks. The median time to progression of boosted metastases has not been reached yet, corresponding to a LTC rate of 73%. Median intracranial PFS was 40 weeks, corresponding to a 1-year PFS of 45.3%. Median OS was 71.5 weeks, corresponding to a 1-year OS of 60%. No obvious acute or late toxicities grade > 2 (NCI CTCAE v4.03) were observed. Dmean to the bilateral hippocampi was 6.585 Gy ± 0.847 (α/β = 2 Gy). Two patients developed a new metastasis in the area of hippocampal avoidance.
conclusionHA-WBRT (simultaneous integrated protection, SIP) with SIB to metastases is a safe and tolerable regime that shows favorable LTC for patients with multiple brain metastases, while it has the potential to minimize the side-effect of cognitive deterioration.
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