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Incidence of Hippocampal Metastases: Laterality and Implications for Unilateral Hippocampal Avoiding Whole Brain Radiotherapy

T. Kazda, A. Misove, P. Burkon, P. Pospisil, L. Hynkova, I. Selingerova, A. Dziacky, R. Belanova, M. Bulik, Z. Rehak, A. Poprach, O. Slama, P. Slampa, O. Slaby, R. Jancalek, R. Lakomy,

. 2018 ; 2018 (-) : 2459608. [pub] 20181213

Jazyk angličtina Země Spojené státy americké

Typ dokumentu klinické zkoušky, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc19027909

Grantová podpora
NV15-33590A MZ0 CEP - Centrální evidence projektů

Introduction: Hippocampi sparing whole brain radiotherapy (WBRT) is an evolving approach in the treatment of patients with multiple brain metastases, pursuing mitigation of verbal memory decline as a consequence of hippocampal radiation injury. Accumulating data are showing different postradiotherapy changes in the left and right hippocampus with a theoretical proposal of only unilateral (dominant, left) hippocampal sparing during WBRT. Method: The aim of this retrospective study is to describe spatial distribution of brain metastases on MRI in a cohort of 260 patients (2595 metastases) and to evaluate distribution separately in the left and right hippocampus and in respective hippocampal avoiding zones (HAZ, region with subtherapeutic radiation dose), including evaluation of location of metastatic mass centre. Results: The median number of brain metastases was three, with lung cancer being the most common type of primary tumour; 36% had single metastasis. Almost 8% of patients had metastasis within hippocampus (1.1% of all metastases) and 18.1% of patients within HAZ (3.3% of all metastases). No statistically significant difference was observed in the laterality of hippocampal involvement, also when the location of centre of metastases was analyzed. There were more patients presenting the centre of metastasis within left (15) versus right (6) HAZ approaching the borderline of statistical significance. Conclusion: No significant difference in the laterality of BM seeding within hippocampal structures was observed. The hypothesized unilateral sparing WBRT would have theoretical advantage in about 50% reduction in the risk of subsequent recurrence within spared regions.

Central European Institute of Technology Masaryk University Kamenice 5 625 00 Brno Czech Republic Department of Comprehensive Cancer Care Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic

Department of Comprehensive Cancer Care Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic

Department of Diagnostic Imaging St Anne's University Hospital Brno Pekarska 53 656 91 Brno Czech Republic Department of Diagnostic Imaging Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic

Department of Neurosurgery St Anne's University Hospital Brno Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic Department of Neurosurgery St Anne's University Hospital Brno Pekarska 53 656 91 Brno Czech Republic

Department of Paediatric Haematology and Oncology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital 5 Uvalu 84 150 06 Praha 5 Czech Republic

Department of Paediatric Haematology and Oncology 2nd Faculty of Medicine Charles University Prague and Motol University Hospital 5 Uvalu 84 150 06 Praha 5 Czech Republic Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic

Department of Radiation Oncology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic Department of Radiation Oncology Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic

Department of Radiation Oncology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic Department of Radiation Oncology Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic Central European Institute of Technology Masaryk University Kamenice 5 625 00 Brno Czech Republic

Department of Radiation Oncology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic Department of Radiation Oncology Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic Regional Centre for Applied Molecular Oncology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic

Department of Radiology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic

Regional Centre for Applied Molecular Oncology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic

Regional Centre for Applied Molecular Oncology Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic Department of Comprehensive Cancer Care Faculty of Medicine Masaryk University Kamenice 5 625 00 Brno Czech Republic Department of Comprehensive Cancer Care Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic Department of Nuclear Medicine and PET Center Masaryk Memorial Cancer Institute Zluty kopec 7 656 53 Brno Czech Republic

Citace poskytuje Crossref.org

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