Why avoid the hippocampus? A comprehensive review

In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and pr...

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Published in	Radiotherapy and oncology Vol. 97; no. 3; pp. 370 - 376
Main Authors	Gondi, Vinai, Tomé, Wolfgang A., Mehta, Minesh P.
Format	Journal Article
Language	English
Published	Ireland Elsevier Ireland Ltd 01.12.2010
Subjects	Brain metastases Brain Neoplasms - pathology Brain Neoplasms - radiotherapy Brain Neoplasms - secondary Cognition Disorders - etiology Cranial Irradiation - adverse effects Cranial Irradiation - methods Disease Progression Executive Function - radiation effects Hematology, Oncology and Palliative Medicine Hippocampal sparing Hippocampus - radiation effects Humans Memory - radiation effects Neurocognitive function Psychomotor Performance - radiation effects Radiotherapy Dosage RTOG 0933 Whole-brain radiotherapy Word Association Tests Brain metastases RTOG 0933 Hippocampal sparing Whole-brain radiotherapy Neurocognitive function
Online Access	Get full text
ISSN	0167-8140 1879-0887 1879-0887
DOI	10.1016/j.radonc.2010.09.013

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Abstract	In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor cells located in subgranular zone of the hippocampus with radiation-induced neurocognitive decline, specifically in terms of short-term memory formation and recall; and present a review of our pilot investigations into the feasibility and risks of sparing the subgranular zone of the hippocampus during whole-brain radiotherapy for brain metastases. We also introduce our phase II cooperative group clinical trial (RTOG 0933) designed to prospectively evaluate the postulated neurocognitive benefit of hippocampal subgranular zone sparing and scheduled to open in 2010.
AbstractList	In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor cells located in subgranular zone of the hippocampus with radiation-induced neurocognitive decline, specifically in terms of short-term memory formation and recall; and present a review of our pilot investigations into the feasibility and risks of sparing the subgranular zone of the hippocampus during whole-brain radiotherapy for brain metastases. We also introduce our phase II cooperative group clinical trial (RTOG 0933) designed to prospectively evaluate the postulated neurocognitive benefit of hippocampal subgranular zone sparing and scheduled to open in 2010. Abstract In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor cells located in subgranular zone of the hippocampus with radiation-induced neurocognitive decline, specifically in terms of short-term memory formation and recall; and present a review of our pilot investigations into the feasibility and risks of sparing the subgranular zone of the hippocampus during whole-brain radiotherapy for brain metastases. We also introduce our phase II cooperative group clinical trial (RTOG 0933) designed to prospectively evaluate the postulated neurocognitive benefit of hippocampal subgranular zone sparing and scheduled to open in 2010. In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor cells located in subgranular zone of the hippocampus with radiation-induced neurocognitive decline, specifically in terms of short-term memory formation and recall; and present a review of our pilot investigations into the feasibility and risks of sparing the subgranular zone of the hippocampus during whole-brain radiotherapy for brain metastases. We also introduce our phase II cooperative group clinical trial (RTOG 0933) designed to prospectively evaluate the postulated neurocognitive benefit of hippocampal subgranular zone sparing and scheduled to open in 2010.In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor cells located in subgranular zone of the hippocampus with radiation-induced neurocognitive decline, specifically in terms of short-term memory formation and recall; and present a review of our pilot investigations into the feasibility and risks of sparing the subgranular zone of the hippocampus during whole-brain radiotherapy for brain metastases. We also introduce our phase II cooperative group clinical trial (RTOG 0933) designed to prospectively evaluate the postulated neurocognitive benefit of hippocampal subgranular zone sparing and scheduled to open in 2010.
Author	Tomé, Wolfgang A. Gondi, Vinai Mehta, Minesh P.
AuthorAffiliation	Department of Medical Physics, University of Wisconsin, Comprehensive Cancer Center, Madison, Wisconsin, USA Department of Human Oncology, University of Wisconsin, Comprehensive Cancer Center, Madison, Wisconsin, USA
AuthorAffiliation_xml	– name: Department of Human Oncology, University of Wisconsin, Comprehensive Cancer Center, Madison, Wisconsin, USA – name: Department of Medical Physics, University of Wisconsin, Comprehensive Cancer Center, Madison, Wisconsin, USA
Author_xml	– sequence: 1 givenname: Vinai surname: Gondi fullname: Gondi, Vinai email: gondi@humonc.wisc.edu organization: Department of Human Oncology , University of Wisconsin Comprehensive Cancer Center, Madison, WI, USA – sequence: 2 givenname: Wolfgang A. surname: Tomé fullname: Tomé, Wolfgang A. organization: Department of Human Oncology , University of Wisconsin Comprehensive Cancer Center, Madison, WI, USA – sequence: 3 givenname: Minesh P. surname: Mehta fullname: Mehta, Minesh P. organization: Department of Human Oncology , University of Wisconsin Comprehensive Cancer Center, Madison, WI, USA
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/20970214$$D View this record in MEDLINE/PubMed
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Keywords	Brain metastases RTOG 0933 Hippocampal sparing Whole-brain radiotherapy Neurocognitive function
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Snippet	In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of... Abstract In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular...
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SubjectTerms	Brain metastases Brain Neoplasms - pathology Brain Neoplasms - radiotherapy Brain Neoplasms - secondary Cognition Disorders - etiology Cranial Irradiation - adverse effects Cranial Irradiation - methods Disease Progression Executive Function - radiation effects Hematology, Oncology and Palliative Medicine Hippocampal sparing Hippocampus - radiation effects Humans Memory - radiation effects Neurocognitive function Psychomotor Performance - radiation effects Radiotherapy Dosage RTOG 0933 Whole-brain radiotherapy Word Association Tests
Title	Why avoid the hippocampus? A comprehensive review
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