Evidence map›Paper›PMID 39718983›Full record

Trial reportNeuro-oncology2025

Hippocampal avoidance prophylactic cranial irradiation (HA-PCI) for small-cell lung cancer better preserves white matter networks compared to conventional PCI.

Rob Colaes, Jeroen Blommaert, Maarten Lambrecht, Michiel B de Ruiter, Pim Pullens, Dirk de Ruysscher, José Belderbos, Stefan Sunaert, Sanne B Schagen, Sabine Deprez

Registry-linked trialAbstract readMulticenter StudyRandomized Controlled TrialClinical Trial, Phase III
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01780675 (Prophylactic Cranial Irradiation With or Without Hippocampal Avoidance in SCLC a Randomized Phase III Trial), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01780675 phase3completednot on this map

Prophylactic Cranial Irradiation With or Without Hippocampal Avoidance in SCLC a Randomized Phase III Trial

TypeinterventionalSponsorThe Netherlands Cancer InstituteRan2013 to 2022Enrolled168ConditionsSmall Cell Lung Cancer, Lung CancerArmsRadiation Prophylactic Cranial Irradiation, Radiation Hippocampal Avoidance PCI
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Rob ColaesLeuven Cancer Institute, KU Leuven, Leuven, Belgium.ORCID 0009-0009-2553-415X
Jeroen BlommaertDepartment of Oncology, KU Leuven, Leuven, Belgium.
Maarten LambrechtDepartment of Oncology, KU Leuven, Leuven, Belgium.ORCID 0000-0002-8746-2691
Michiel B de RuiterDivision of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Pim PullensDepartment of Medical Imaging, Ghent University Hospital, Ghent Institute for Functional and Metabolic Imaging, IBITech/MEDISIP, Department of Engineering and Architecture, Ghent University, Ghent, Belgium.
Dirk de RuysscherRadiation Oncology (MAASTRO), School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
José BelderbosRadiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.ORCID 0000-0002-6434-6436
Stefan SunaertLeuven Brain Institute, KU Leuven, Leuven, Belgium.
Sanne B SchagenBrain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
Sabine DeprezLeuven Cancer Institute, KU Leuven, Leuven, Belgium.ORCID 0000-0001-7451-5355

Funding

Dutch Cancer Society 2013-6096Science and Technology in Flanders IWT 130262Vlaamse Liga Tegen Kanker 1003-105
6 · The paper itself

Abstract

backgroundHippocampal avoidance during prophylactic cranial irradiation (HA-PCI) is proposed to reduce neurocognitive decline, while preserving the benefits of PCI. We evaluated whether (HA-)PCI induces changes in white matter (WM) microstructure and whether sparing the hippocampus has an impact on preserving brain network topology. In addition, we evaluated associations between topological metrics with hippocampal volume and neuropsychological outcomes.

methodsIn this multicenter randomized phase 3 trial (NCT01780675), small-cell lung cancer (SCLC) patients underwent neuropsychological testing and diffusion tensor imaging (DTI) before, 4 months (33 PCI, 37 HA-PCI) and 1 year (19 PCI, 17 HA-PCI) after (HA-)PCI. Changes in WM microstructure were investigated using whole-brain voxel-based analysis of fractional anisotropy (FA) and mean diffusivity (MD). Both hippocampal and whole-brain graph measures were used to evaluate the topological organization of structural networks. Correlation analysis was performed to associate topological metrics with neuropsychological outcomes and hippocampal volume.

resultsBoth HA-PCI and PCI were associated with decreased FA in major WM tracts, such as the corpus callosum, at 4 months and 1 year post-treatment. While these FA decreases did not differ significantly between treatment groups, only PCI demonstrated increased MD over time. In addition, PCI showed decreased global efficiency and increased characteristic path length over time when compared with HA-PCI. Significant correlations were found between whole-brain graph measures and neuropsychological outcomes.

conclusionWhile both techniques induce important changes in the WM microstructure, HA-PCI might better preserve the topological organization of brain networks than PCI. The neuroprotective role of hippocampal sparing still needs further investigation.

Indexed as

Brain NeoplasmsCranial IrradiationHippocampusLung NeoplasmsSmall Cell Lung CarcinomaWhite MatterAgedDiffusion Tensor ImagingFemaleFollow-Up StudiesHumansMaleMiddle AgedNeuropsychological TestsPrognosiscognitiondiffusion tensor imagingGraph theoryhippocampal avoidance during prophylactic cranial irradiationsmall-cell lung cancer

Identifiers

PMID39718983
PMCPMC12187368

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Registered trials

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