News | Radiation Therapy | October 23, 2018

Hippocampal Sparing Prevents Whole-Brain Radiotherapy Cognitive Side Effects

New study presented at ASTRO provides practice-changing evidence

Hippocampal Sparing Prevents Whole-Brain Radiotherapy Cognitive Side Effects. #ASTRO #ASTRO18 #ASTRO2018

October 23, 2018 — Whole-brain radiotherapy can be delivered more safely to patients with brain metastases by avoiding the hippocampus, according to a randomized phase III NRG Oncology trial. Trial results were presented at the American Society for Radiation Oncology (ASTRO) annual meeting, Oct. 21-24 in San Antonio, Texas.

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.

“This study demonstrates that we can deliver whole brain radiotherapy with similar cognitive outcomes as radiosurgery,” said lead author and co-principal investigator of the phase III trial 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. “These trial 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.”

Brain metastases, cancer cells that have spread to the brain from primary tumors in other organs, is one of the most common cancer conditions managed by radiation oncologists. Due to concerns about cognitive decline, whole-brain radiotherapy is currently often the last resort, even though it is one of the most effective treatments for brain metastases.

“This hippocampal-sparing approach reduces both the risk of growth of new brain metastases and the risk of cognitive decline, and no prior study has ever demonstrated this dual effect,” added Walter J. Curran, M.D., executive director of the Winship Cancer Institute at Emory University and an NRG Oncology Group Chair.

By establishing that the hippocampal region is sensitive to radiation, treatment plans for brain metastases or other brain tumors can employ advanced techniques such as intensity-modulated radiation therapy (IMRT) or proton therapy to reduce dose to the hippocampus and offer brain therapy with less toxicity.

“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,” said Gondi.

Read the study abstract here.

Read more about the Late-breaking Radiation Therapy Clinical Trials at ASTRO 2018.
 

For more information: www.astro.org

Related Content

Videos | Radiation Oncology | September 20, 2019
Anne Hubbard, MBA, director of health policy for ASTRO, explains the details and purpose of the proposed Radiation On
Densitas Wins Major Procurement of Breast Density Software for DIMASOS Breast Screening Trial
News | Breast Density | September 20, 2019
Densitas Inc. announced it has won a procurement of its densitas densityai software for deployment in up to 24 breast...
Videos | Radiation Therapy | September 20, 2019
ITN Associate Editor Jeff Zagoudis speaks with...
Aktina Showcases New Radiotherapy Patient Immobilization Solutions at ASTRO 2019
News | Patient Positioning Radiation Therapy | September 20, 2019
Aktina Medical introduced several new products at the 2019 American Society for Radiation Oncology (ASTRO) annual...
Varian Announces Multi-room Configuration for ProBeam 360 Proton Therapy System
News | Proton Therapy | September 20, 2019
Varian announced its ProBeam 360° proton therapy system is now available in a multi-room configuration. The ProBeam 360...
Screening Mammography Could Benefit Men at High Risk of Breast Cancer
News | Mammography | September 18, 2019
Selective mammography screening can provide potentially lifesaving early detection of breast cancer in men who are at...
Anne Hubbard, MBA, director of health policy for the American Society for Radiation Oncology

Anne Hubbard, MBA, director of health policy for the American Society for Radiation Oncology (ASTRO), explains the details of the proposed radiation oncology alternative payment model (APM), and issues ASTRO has raised with the model, at the 2019 ASTRO annual meeting in Chicago.

News | Radiation Oncology | September 18, 2019
During its annual meeting in September, the American Society for Radiation Oncology (ASTRO) issued a response to the...
Radiation After Immunotherapy Improves Progression-free Survival for Some Metastatic Lung Cancer Patients
News | Lung Cancer | September 18, 2019
Adding precisely aimed, escalated doses of radiation after patients no longer respond to immunotherapy reinvigorates...
IBA Gathers Experts on Flash Irradiation During ASTRO
News | Proton Therapy | September 17, 2019
IBA (Ion Beam Applications SA, held its third Victoria Consortium Meeting focusing on Flash irradiation at the 2019...
Noninvasive Radioablation Offers Long-term Benefits to High-risk Heart Arrhythmia Patients
News | Radiation Therapy | September 17, 2019
September 17, 2019 — Treating high-risk heart patients with a single, high dose of...