Hippocampus Radiotherapy

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When cancer metastases to the brain, radiation therapy is the treatment of choice. And while this treatment prolongs life, mental function is affected. A new study examines a technique that may preserve the mental functions. Researchers found that limiting the amount of radiation to the hippocampus during whole brain radiotherapy may preserve cancer patients' memory function. The purpose of this review is to provide a brief overview of studies that provide a rationale for hippocampal avoidance. Also, to summarize published studies in order to help radiation therapist understand the clinical usage of these innovated complex and challenging techniques. The hippocampus is a paired brain structure which resembles a seahorse and is located in the ventromedial part of the temporal lobes.…show more content…
This technique is possible by using intensity modulated radiotherapy enabling high conformal radiotherapy with a steep dose gradient in locations with high priority of sparing. Although, providing this modern therapy places high demands on the accuracy of radiation and precision of planning. Modern IMRT techniques allow for sparing of the hippocampus with acceptable target coverage and equality. Using Helical Tomotherapy and LINAC-based intensity-modulated radiotherapy (IMRT), they have successfully been able to spare the hippocampus. For a prescription dose of 30 Gy in 10 fractions, the median and maximum dose received by the hippocampus is 5.5 Gy to 12.8 Gy for helical tomotherapy. LINAC-based IMRT were 7.8 Gy to 15.3 Gy. Using modern IMRT techniques, we have been able to reduce the mean dose per fraction to the hippocampus by 87% to 0.49 Gy2 using helical tomotherapy, and by 81% to 0.73 Gy2 using LINAC-based IMRT. These reduce percentages of therapeutic doses on the hippocampus suggest it will lessen neurocognitive

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