Trial reportNeuro-oncology2020
Hippocampal radiotherapy dose constraints for predicting long-term neurocognitive outcomes: mature data from a prospective trial in young patients with brain tumors.
Trial report in Neuro-oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers.
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Who cites it
36 citing papers in PubMed, 64 citations in OpenAlex.
- Memantine to preserve memory and neurocognition following craniospinal irradiation (MEMENTO): a phase 3 randomized controlled trial.BMC cancer · 2026Trial
- High-precision radiotherapy achieves excellent long-term control and preserves function in pediatric craniopharyngioma-Subset analysis of a randomized trial.Neuro-oncology · 2025Trial
- Proton versus photon radiotherapy in adults with primary brain tumors evaluating functional survival: a phase 3 randomized controlled trial study protocol (PRIDE).Radiation oncology (London, England) · 2026Article
- Chronic Neurological Complications of Brain Tumors and Brain Tumor Treatments.Current neurology and neuroscience reports · 2025Review
- Pediatric CNS Radiation Oncology: Recent Developments and Novel Techniques.Current oncology (Toronto, Ont.) · 2025Review
- Reirradiation using helical tomotherapy-based hypofractionated stereotactic radiotherapy for 19 brain metastases after the second recurrence of distant brain failure: a case report and literature review.Translational lung cancer research · 2025Article
- Evaluation of hippocampus-sparing VMAT versus conventional VMAT in locally advanced nasopharyngeal carcinoma: a dosimetric and biological analysis.Frontiers in oncology · 2025Article
- Observational
- Impact of stereotactic radiotherapy for craniopharyngioma: a large, academic hospital cohort.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Article
- Comparison of different target volume delineation strategies based on recurrence patterns in adjuvant radiotherapy for glioblastoma.Neuro-oncology practice · 2024Article
- Comparison of conventional and hippocampus-sparing radiotherapy in nasopharyngeal carcinoma: In silico study and systematic review.Clinical and translational radiation oncology · 2024Article
- Modern Radiation Treatment Planning Parameters and Outcomes in Pediatric Tectal Gliomas.Advances in radiation oncology · 2024Article
- Assessment of Radiation Dosage to the Hippocampi during Treatment of Multiple Brain Metastases Using Gamma Knife Therapy.Medicina (Kaunas, Lithuania) · 2024Article
- Unilateral hippocampal sparing during whole brain radiotherapy for multiple brain metastases: narrative and critical review.Frontiers in oncology · 2024Review
- Hippocampal sparing in whole-brain radiotherapy for brain metastases: controversy, technology and the future.Frontiers in oncology · 2024Review
- Robustness and dosimetric verification of hippocampal-sparing craniospinal pencil beam scanning proton plans for pediatric medulloblastoma.Physics and imaging in radiation oncology · 2024Article
- Hippocampus-sparing volume-modulated arc therapy in patients with World Health Organization grade II glioma: a feasibility study.Frontiers in oncology · 2024Article
- Neurocognitive Dysfunction After Treatment for Pediatric Brain Tumors: Subtype-Specific Findings and Proposal for Brain Network-Informed Evaluations.Neuroscience bulletin · 2023Review
- Mitigating Radiotoxicity in the Central Nervous System: Role of Proton Therapy.Current treatment options in oncology · 2023Review
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHippocampus is considered to be the seat for neurocognitive functions. Avoidance of hippocampus during radiotherapy to brain may serve to preserve various domains of neurocognition. We aimed to derive radiotherapy dose constraints to hippocampi for preserving neurocognition in young patients with brain tumors by measuring various neurocognitive parameters.
methodsForty-eight patients with residual/progressive benign or low-grade brain tumors treated with stereotactic conformal radiotherapy (SCRT) to a dose of 54 Gy in 30 fractions underwent prospective neuropsychological assessments at baseline before SCRT and at 6 months and 2, 3, 4, and 5 years. Hippocampi were drawn as per the Radiation Therapy Oncology Group atlas. Longitudinal change in intelligence quotient scores was correlated with hippocampal doses.
resultsMean volume of bilateral hippocampi was 4.35 cc (range: 2.12-8.41 cc). Craniopharyngioma was the commonest histologic subtype. A drop of >10% in mean full-scale intelligence quotient (FSIQ) scores at 3 and 5 years post SCRT was observed in patients in whom left hippocampus received a mean dose of 30.7 Gy (P = 0.04) and 31 Gy (P = 0.04), respectively. Mean performance quotient (PQ) scores dropped > 10% at 5 years when the left hippocampus received a dose of > 32 Gy (P = 0.03). There was no significant correlation of radiotherapy doses with verbal quotient, or with doses received by the right hippocampus. Multivariate analysis revealed young age (<13 y) and left hippocampus dose predicted for clinically relevant decline in certain neurocognitive domains.
conclusionsA mean dose of ≤30 Gy to the left hippocampus as a dose constraint for preserving intelligence quotient is suggested. KEY POINTS: 1. Children and young adults with benign and low-grade gliomas survive long after therapy.2. Higher dose to the hippocampi may result in long-term neurocognitive impairment.3. Mean dose of <30 Gy to left hippocampus could be used as a pragmatic dose constraint to prevent long-term neurocognitive decline.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.