AANS Neurosurgeon | Volume 28, Number 3, 2019

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Hippocampal avoidance using IMRT now recommended as standard of care for brain metastases

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Patients with brain metastases who received whole-brain radiotherapy that avoided memory-specific hippocampal neural stem cells experienced preserved cognitive function and reported fewer neurologic symptoms and better cognition over time, according to results from an NRG Oncology clinical trial.

Dr. Vinai Gondi, director of research at the Northwestern Medicine Chicago Proton Center and co-director of the Brain Tumor Center at Northwestern Medicine Cancer Center Warrenville, presented updated results of the phase III trial. Gondi was lead author and co-principal investigator of the trial. Dr. Paul D. Brown of the Mayo Clinic was also co-principal investigator of the trial.

“We hypothesized that by using advanced radiotherapy techniques to spare the hippocampal neural stem cell compartment from significant doses of radiation, we may be able to prevent radiotherapy-related adverse cognitive effects,” Gondi said. “Now with longer-term follow-up, results confirm that hippocampal avoidance using intensity modulated radiation therapy should be considered the standard of care for patients with brain metastases who are eligible to receive whole-brain radiotherapy.”

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