Hippocampal-Sparing Whole-Brain Radiotherapy for Lung Cancer.
Brain metastases occur in 20% to 40% of lung cancer patients. Whole-brain radiotherapy (WBRT) has long been considered the treatment of choice for many patients with lung cancer, because of its wide availability, ease of delivery, and effectiveness in prolonging survival. However, WBRT is also associated with several side effects, such as decline in memory and other cognitive functions. There exists significant preclinical and clinical evidence that radiation-induced injury to the hippocampus correlates with neurocognitive decline of patients who receive WBRT. Technological advances in treatment planning and delivery facilitate the use of hippocampal-sparing (HS) WBRT as prophylactic cranial irradiation or the primary treatment modality for lung cancer patients with brain metastases. In this review, we provide a detailed and comprehensive discussion of the safety profile, techniques for hippocampus-sparing, and the clinical evidence of HS-WBRT for lung cancer patients.
Department of Radiation Oncology, General Hospital of Ningxia Medical University, and Cancer Institute, Ningxia Medical University, Yinchuan, Ningxia, China.
Ren
R
Zhao
Department of Radiation Oncology, General Hospital of Ningxia Medical University, and Cancer Institute, Ningxia Medical University, Yinchuan, Ningxia, China.
Wei
W
Kong
Department of Radiation Oncology, General Hospital of Ningxia Medical University, and Cancer Institute, Ningxia Medical University, Yinchuan, Ningxia, China.
Jun
J
Shang
Department of Radiation Oncology, General Hospital of Ningxia Medical University, and Cancer Institute, Ningxia Medical University, Yinchuan, Ningxia, China.
Hong
H
Zhe
Department of Radiation Oncology, General Hospital of Ningxia Medical University, and Cancer Institute, Ningxia Medical University, Yinchuan, Ningxia, China. Electronic address: fdwyy1981@hotmail.com.
Yan-Yang
YY
Wang
D001932:Brain Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D016371:Cranial Irradiation; D006624:Hippocampus / Q000528:radiation effects*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D059351:Organ Sparing Treatments / Q000379:methods*; D011379:Prognosis
Brain metastases; Cognitive function; Hippocampus; Neurotoxicity; Planning study