News | Radiation Therapy | September 24, 2019

Patients benefit from preserved cognitive function, fewer neurological symptoms

Hippocampal Avoidance Using IMRT Now Recommended as Standard of Care for Brain Metastases

September 24, 2019 — Patients with brain metastases who received whole-brain radiotherapy that avoided memory-specific hippocampal neural stem cells experienced preserved cognitive function, according to results from an NRG Oncology clinical trial. Those patients also reported fewer neurologic symptoms and better cognition over time. The results were presented at the 2019 American Society for Radiation Oncology (ASTRO) Annual Meeting, Sept. 15-18 in Chicago.

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

To study the hypothesis that radiation to the hippocampal stem cells plays a role in cognitive decline, 518 patients were randomized to whole brain radiotherapy plus memantine with or without hippocampal avoidance. The results of the clinical trial found a 26 percent relative reduction in risk of cognitive toxicity following whole brain radiation therapy with hippocampal avoidance versus whole-brain radiotherapy. The cognitive function benefit of hippocampal avoidance did not differ by age.

Over time, patients who received treatment that avoided the hippocampus continued to maintain measurable improvements in cognition. They self-reported fewer neurologic symptoms, less interference of neurologic symptoms with their daily activities and fewer problems remembering things in their daily lives. These patients experienced toxicity, intracranial progression-free survival and overall survival outcomes similar to those experienced by patients who had whole-brain radiotherapy.

“These results revolutionize our understanding of the cognitive effects of brain irradiation in a manner that has far-reaching implications in terms of the safer radiotherapy treatment of primary or metastatic brain tumors,” Gondi said. “Our phase III trial not only provides evidence for practice change in the management of brain metastases, but also builds upon decades of preclinical and clinical research to definitely establish the hippocampus as a radiosensitive and cognition-specific organ at risk during brain irradiation.”

Watch the VIDEO: Preserving Neurocognitive Function During Whole-Brain Radiotherapy, an interview with Gondi about the trial at ASTRO 2019.

For more information: www.astro.org

Related Content

Additional coverage from ASTRO 2019


Related Content

News | Radiation Oncology

February 14, 2024 — Accuray Incorporated announced that the team at Quebec’s Montérégie Integrated Cancer Center, part ...

Time February 14, 2024
arrow
News | Radiation Oncology

February 12, 2024 — Radformation, a global pioneer in radiation oncology software solutions, is pleased to announce its ...

Time February 12, 2024
arrow
News | Quality Assurance (QA)

February 12, 2024 — IBA, a world leader in particle accelerator technology and a world-leading provider of dosimetry and ...

Time February 12, 2024
arrow
News | Radiation Therapy

February 8, 2024 — RaySearch Laboratories AB announced that The Royal Marsden NHS Foundation Trust, a specialist cancer ...

Time February 08, 2024
arrow
Videos | RSNA

At RSNA23, Imaging Technology News (ITN) spoke with Bhvita Jani, principal analyst at Signify Research, about ...

Time February 07, 2024
arrow
News | Interventional Radiology

February 6, 2024 — RenovoRx, Inc., a clinical-stage biopharmaceutical company developing novel precision oncology ...

Time February 06, 2024
arrow
News | SNMMI

February 6, 2024 — The Society of Nuclear Medicine and Molecular Imaging (SNMMI) held its 2024 SNMMI Mid-Winter Meeting ...

Time February 06, 2024
arrow
News | Treatment Planning

February 2, 2024 — RaySearch Laboratories announced that the number of radiotherapy centers that have chosen RayStation ...

Time February 02, 2024
arrow
Feature | Radiology Business | By Melinda Taschetta-Millane

It's a new year, and as another month comes to a close, ITN takes a look at the Top 10 most-read pieces of content from ...

Time February 01, 2024
arrow
News | Radiation Oncology

January 30, 2024 — The largest professional societies representing radiation oncology physicians in the United States ...

Time January 30, 2024
arrow
Subscribe Now