[an error occurred while processing this directive] | [an error occurred while processing this directive]
Clinical value of hippocampal gyrus protection in whole brain radiotherapy
Dong Xin,Zhou Zongmei
Department of Radiation Oncology,National Cancer Center/Cancer Hospital,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100021,China
Abstract At present, conventional whole brain radiotherapy is the standard treatment for brain metastases and prophylactic cranial irradiation, and it can improve patients’ clinical symptoms and survival. However, whole brain radiotherapy may induce cognitive function impairment and affect patients’ long-term quality of life. The newest radiotherapy technology can protect the hippocampal gyrus during whole brain radiotherapy and then protect cognitive function and improve quality of life. This article reviews the methods and clinical value of hippocampal gyrus protection in whole brain radiotherapy, as well as related advances.
Dong Xin,Zhou Zongmei. Clinical value of hippocampal gyrus protection in whole brain radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 526-529.
Dong Xin,Zhou Zongmei. Clinical value of hippocampal gyrus protection in whole brain radiotherapy[J]. Chinese Journal of Radiation Oncology, 2016, 25(5): 526-529.
[1]Seute T,Leffers P,Wilmink JT,et al. Response of asymptomatic brain metastases from small-cell lung cancer to systemic first-line chemotherapy[J].J Clin Oncol,2006,24(13):2079-2083.DOI:10.1200/JCO.2005.03.2946. [2]Postmus PE,Haaxma-Reiche H,Smit EF,et al. Treatment of brain metastases of small-cell lung cancer:comparing teniposide and teniposide with whole-brain radiotherapy—a phase Ⅲ study of the European Organization for the Research and Treatment of Cancer Lung Cancer Cooperative Group[J].J Clin Oncol,2000,18(19):3400-3408. [3]Aupérin A,Arriagada R,Pignon JP,et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission[J].New Engl J Med,1999,341(7):476-484.DOI:10.1056/NEJM199908123410703. [4]Slotman B,Faivre-Finn C,Kramer G,et al. Prophylactic cranial irradiation in extensive small-cell lung cancer[J].New Engl J Med,2007,357(7):664-672.DOI:10.1056/NEJMoa071780. [5]Sun A,Bae K,Gore EM,et al. Phase Ⅲ trial of prophylactic cranial irradiation compared with observation in patients with locally advanced non–small-cell lung cancer:neurocognitive and quality-of-life analysis[J].J Clin Oncol,2011,29(3):279-286.DOI:10.1200/JCO.2010.29.6053. [6]Cross NE,Glantz MJ.Neurologic complications of radiation therapy[J].Neurol Clin,2003,21(1):249-277.DOI:10.1016/S0733-8619(02)00031-2. [7]Le Péchoux C,Laplanche A,Faivre-Finn C,et al. Clinical neurological outcome and quality of life among patients with limited small-cell cancer treated with two different doses of prophylactic cranial irradiation in the intergroup phase Ⅲ trial (PCI99-01,EORTC 22003-08004,RTOG 0212 and IFCT 99-01)[J].Ann Oncol,2011,22(5):1154-1163.DOI:10.1093/annonc/mdq576. [8]Slotman BJ,Mauer ME,Bottomley A,et al. Prophylactic cranial irradiation in extensive disease small-cell lung cancer:short-term health-related quality of life and patient reported symptoms:results of an international phase Ⅲ randomized controlled trial by the EORTC radiation oncology and lung cancer groups[J].J Clin Oncol,2009,27(1):78-84.DOI:10.1200/JCO.2008.17.0746. [9]Grosshans DR,Meyers CA,Allen PK,et al. Neurocognitive function in patients with small cell lung cancer:effect of prophylactic cranial irradiation[J].Cancer,2008,112(3):589-595.DOI:10.1002/cncr.23222. [10]Eriksson PS,Perfilieva E,Bjrk-Eriksson T,et al. Neurogenesis in the adult human hippocampus[J].Nat Med,1998,4(11):1313-1317.DOI:10.1038/3305. [11]Morshead CM,Reynolds BA,Craig CG,et al. Neural stem cells in the adult mammalian forebrain:a relatively quiescent subpopulation of subependymal cells[J].Neuron,1994,13(5):1071-1082.DOI:10.1016/0896-6273(94)90046-9. [12]Becker S.A computational principle for hippocampal learning and neurogenesis[J].Hippocampus,2005,15(6):722-738.DOI:10.1002/hipo.20095. [13]Wiskott L,Rasch MJ,Kempermann G.A functional hypothesis for adult hippocampal neurogenesis:avoidance of catastrophic interference in the dentate gyrus[J].Hippocampus,2006,16(3):329-343.DOI:10.1002/hipo.20167. [14]Aimone JB,Wiles J,Gage FH.Potential role for adult neurogenesis in the encoding of time in new memories[J].Nat Neurosci,2006,9(6):723-727.DOI:10.1038/nn1707. [15]Mizumatsu S,Monje ML,Morhardt DR,et al. Extreme sensitivity of adult neurogenesis to low doses of X-irradiation[J].Cancer Res,2003,63(14):4021-4027. [16]Kim JS,Lee HJ,Kim JC,et al. Transient impairment of hippocampus-dependent learning and memory in relatively low-dose of acute radiation syndrome is associated with inhibition of hippocampal neurogenesis[J].J Radiat Res,2008,49(5):517-526.DOI:10.1269/jrr.08020. [17]Bernad D,Collins L,Fiocco A,et al. Analysis of structural changes in hippocampal and amygdala volume after systemic therapy and prophylactic cranial irradiation in patients with limited stage-small cell lung cancer[J].Int J Radiat Oncol Biol Phys,2013,87(S2):S103.DOI:10.1016/j.ijrobp.2013.06.267. [18]Redmond KJ,Mahone EM,Terezakis S,et al. Association between radiation dose to neuronal progenitor cell niches and temporal lobes and performance on neuropsychological testing in children:a prospective study[J].Neuro Oncol,2013,15(3):360-369.DOI:10.1093/neuonc/nos303. [19]Gondi V,Hermann BP,Mehta MP,et al. Hippocampal dosimetry predicts neurocognitive function impairment after fractionated stereotactic radiotherapy for benign or low-grade adult brain tumors[J].Int J Radiat Oncol Biol Phys,2012,83(4):e487-e493.DOI:10.1016/j.ijrobp.2011.10.021. [20]Gondi V,Tomé WA,Mehta MP.Why avoid the hippocampus? a comprehensive review[J].Radiother Oncol,2010,97(3):370-376.DOI:10.1016/j.radonc.2010.09.013. [21]Marsh JC,Herskovic AM,Gielda BT,et al. Intracranial metastatic disease spares the limbic circuit:a review of 697 metastatic lesions in 107 patients[J].Int J Radiat Oncol Biol Phys,2010,76(2):504-512.DOI:10.1016/j.ijrobp.2009.02.038. [22]Ghia A,Tomé WA,Thomas S,et al. Distribution of brain metastases in relation to the hippocampus:implications for neurocognitive functional preservation[J].Int J Radiat Oncol Biol Phys,2007,68(4):971-977.DOI:10.1016/j.ijrobp.2007.02.016. [23]Gondi V,Tome WA,Marsh J,et al. Estimated risk of perihippocampal disease progression after hippocampal avoidance during whole-brain radiotherapy:safety profile for RTOG 0933[J].Radiother Oncol,2010,95(3):327-331.DOI:10.1016/j.radonc.2010.02.030. [24]Wan JF,Zhang SJ,Wang L,et al. Implications for preserving neural stem cells in whole brain radiotherapy and prophylactic cranial irradiation:a review of 2270 metastases in 488 patients[J].J Radiat Res,2013,54(2):285-291.DOI:10.1093/jrr/rrs085. [25]Harth S,Abo-Madyan Y,Zheng L,et al. Estimation of intracranial failure risk following hippocampal-sparing whole brain radiotherapy[J].Radiother Oncol,2013,109(1):152-158.DOI:10.1016/j.radonc.2013.09.009. [26]Blomstrand M,Brodin NP,Munck Af Rosenschld P,et al. Estimated clinical benefit of protecting neurogenesis in the developing brain during radiation therapy for pediatric medulloblastoma[J].Neuro Oncol,2012,14(7):882-889.DOI:10.1093/neuonc/nos120. [27]Marsh JC,Gielda BT,Herskovic AM,et al. Sparing of the hippocampus and limbic circuit during whole brain radiation therapy:a dosimetric study using helical tomotherapy[J].J Med Imaging Radiat Oncol,2010,54(4):375-382.DOI:10.1111/j.1754-9485.2010.02184.x. [28]Gondi V,Tolakanahalli R,Mehta MP,et al. Hippocampal-sparing whole-brain radiotherapy:a “How-To” technique using helical tomotherapy and linear accelerator–based intensity-modulated radiotherapy[J].Int J Radiat Oncol Biol Phys,2010,78(4):1244-1252.DOI:10.1016/j.ijrobp.2010.01.039. [29]Hsu F,Carolan H,Nichol A,et al. Whole brain radiotherapy with hippocampal avoidance and simultaneous integrated boost for 1-3 brain metastases:a feasibility study using volumetric modulated arc therapy[J].Int J Radiat Oncol Biol Phys,2010,76(5):1480-1485.DOI:10.1016/j.ijrobp.2009.03.032. [30]Prokic V,Wiedenmann N,Fels F,et al. Whole brain irradiation with hippocampal sparing and dose escalation on multiple brain metastases:a planning study on treatment concepts[J].Int J Radiat Oncol Biol Phys,2013,85(1):264-270.DOI:10.1016/j.ijrobp.2012.02.036. [31]Gondi V,Pugh SL,Tome WA,et al. Preservation of memory with conformal avoidance of the hippocampal neural stem-cell compartment during whole-brain radiotherapy for brain metastases (RTOG 0933):a phase Ⅱ multi-institutional trial[J].J Clin Oncol,2014,32(34):3810-3816.DOI:10.1200/JCO.2014.57.2909. [32]董昕,周宗玫,苗俊杰,等.局限期小细胞肺癌全脑预防照射保护海马回区的初步临床研究[J].中华放射肿瘤学杂志,2015,24(2):131-136.DOI:10.3760/cma.j.issn.1004-4221.2015.02.007. Dong X,Zhou ZM,Miao JJ,et al. Primary clinical study of hippocampal-sparing prophylactic cranial irradiation in limited-stage small-cell lung cancer[J].Chin J Radiat Oncol,2015,24(2):131-136.DOI:10.3760/cma.j.issn.1004-4221.2015.02.007.
2016, Vol. 25 
