Department of Radiation Oncology,307 Clinical College,Anhui Medical University,Beijing 100071,China (Che DM,Wu SHK);Department of Radiation Oncology,307 Hospital of PLA,Beijing 100071,China (Che DM,Meng XY,Shen G,Sun B,Cong Y,Liu CH,Wang Q,Wang JL,Hao RM,Wu SK)
Abstract：Objective To investigate the incidence of and high-risk factors for hippocampal metastasis (HM) in patients with brain metastases of lung cancer, to determine the safety of hippocampus-sparing whole brain radiotherapy (HS-WBRT), and to find out patients eligible for HS-WBRT. Methods A retrospective study was performed on clinical data from 345 patients with brain metastases of lung cancer who were admitted to our hospital from 2011 to 2014. The hippocampus plus a 5-mm margin was delineated. Univariate and multivariate logistic analyses were used to identify high-risk factors for hippocampal metastasis. The Cox model was used for multivariate prognostic analysis. Results In the 345 patients, there were 1621 intracranial metastatic lesions. Sixteen (4.6%) of the 345 patients and 16(0.99%) of the 1621 intracranial metastatic lesions had hippocampal metastasis;42(12.2%) of the 345 patients and 45(2.78%) of the 1621 intracranial metastatic lesions had metastasis in the hippocampus plus a 5-mm margin. The univariate and multivariate logistic analyses showed that the number of brain metastases was correlated with hippocampal metastasis (HR=1.14,P=0.000). In the 139 patients with intracranial progression after treatment, 17(12.2%) had hippocampal metastasis recurrence. The Cox prognostic analysis showed that tumor stage and genetic information were related to the overall survival in patients with brain metastases. Conclusions The number of brain metastases is a high-risk factor for hippocampal metastasis. The lung cancer patients with more brain metastases have a higher incidence of hippocampal metastasis. HS-WBRT is recommended for lung cancer patients with fewer brain metastases, early-stage disease, and genetic mutations or rearrangement.
Chen Dongmei,Meng Xiangying,Shen Ge et al. Incidence and the high-risk factors of intracranial metastases in the perhippocampus regoin in 345 patients with lung cancer[J]. Chinese Journal of Radiation Oncology, 2017, 26(2): 138-143.
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2017, Vol. 26 
