Central Nervous System

PV QA 2 - Poster Viewing Q&A 2

MO_8_2674 - Hippocampal avoidance in Whole Brain Radiation Therapy for Metastases - Comparative Neurocognitive and Dosimetric Assessment

Monday, October 22
10:45 AM - 12:15 PM
Location: Innovation Hub, Exhibit Hall 3

Hippocampal avoidance in Whole Brain Radiation Therapy for Metastases – Comparative Neurocognitive and Dosimetric Assessment
V. Pareek; Jupiter Hospital, Mumbai, India

Purpose/Objective(s): Hippocampus is associated with formation and storage of new memory and irradiation of the same during whole brain radiotherapy in brain metastases leads to decline in the neurocognitive function. Recent advancements in radiation delivery in form of IMRT, Hippocampal avoidance has been made possible. We analyze feasibility of hippocampal sparing and associated neurocognitive and dosimetric assessment.

Materials/Methods: Between June 2016 to October 2017, 75 patients diagnosed radiologically and clinically with brain metastases were included in the study. Mini Mental State Examination (MMSE) and quality of life assessment with EORTC BN20 questionnaire were assessed along with dosimetry. Patients were assessed at baseline and followed by at 1, 3 and 6 months respectively. Factors were compared with the historical group with relation to quality of life especially neurocognitive functioning. Wilcoxon test for multiple comparisons was calculated to detect significant differences in global QoL scores. Dose received in WBRT was 30Gy in 10 fractions in both arms with boost of 9Gy in single metastases.

Results: Median age of accrued 75 patients was 49 years. Median D100% and Dmax to contralateral hippocampus was 7.1Gy and 16.7Gy. With IMRT, the doses to other critical structures were reduced. Patients treated with IMRT were found to have achieved desired dose constraints to hippocampus. Assessment of neurocognitive function between two groups, there was no difference at 1 month after treatment, however, difference was seen at 3 and 6 months. No difference noted in other aspects of quality of life between two groups. No severe toxicities (Grade 3 and 4) were noted in either group. Median survival in the HA-WBRT arm was found to be 9.8 months.

Conclusion: Conformal avoidance of hippocampus during WBRT is associated with improved neurocognitive function and quality of life. IMRT has found to provide better dosimetric outcomes in HA-WBRT.

Author Disclosure: V. Pareek: None.

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MO_8_2674 - Hippocampal avoidance in Whole Brain Radiation Therapy for Metastases - Comparative Neurocognitive and Dosimetric Assessment



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