A prospective study of hippocampal-avoidance prophylactic cranial irradiation in small cell lung cancer patients with limited stage
10.3760/cma.j.cn113030-20190505-00158
- VernacularTitle:局限期小细胞肺癌海马保护脑预防性照射初步研究
- Author:
Yue KONG
1
;
Tieming XIE
;
Lei SHI
;
Fenglei DU
;
Xiao HU
;
Qing GU
;
Jin WANG
;
Min FANG
;
Mengyuan CHEN
;
Yujin XU
;
Honglian MA
;
Ming CHEN
;
Yuanyuan CHEN
Author Information
1. 中国科学院大学附属肿瘤医院（浙江省肿瘤医院）胸部放疗科中国科学院肿瘤与基础医学研究所，杭州 310022
- From:
Chinese Journal of Radiation Oncology
2020;29(8):629-632
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the feasibility of hippocampal-avoidance (HA) prophylactic cranial irradiation (PCI) in small cell lung cancer patients (SCLC)(limited stage) after chemotherapy and thoracic radiation.Methods:From June 2016 to March 2019, 40 eligible SCLC patients were recruited and randomly divided into the routine PCI ( n=22) and hippocampal-avoidance PCI (HA-PCI) groups ( n=18). The HA zone was contoured according to the criteria of RTOG 0933. Volumetric-modulated arc therapy (VMAT) was adopted in the HA-PCI group. After radiotherapy, Hopkins verbal learning test (HVLT) and MRI were performed. Results:The average hippocampus volume was (4.01±1.57) cm 3, the average HA volume was (20.13±4.14) cm 3, HA D 100% was (7.19±0.38) Gy and HA D max was (14.38±1.18) Gy. During HVLT, 1-month-after-PCI vs. before-PCI (trial3, trial4, learning, percent retained), 1-month-after-PCI vs. after-PCI (trial3, learning), HA-PCI cohort showed advantages over PCI in HVLT scores. The average follow-up time was (17.00±8.47) months. Two patients with brain metastases which were out of the HAZ received routine PCI. Conclusions:PCI using VMAT technology to protect hippocampus is feasible in dosimetry. The test results indicate that the protective effect of hippocampus protection on memory is worthy of further promotion in clinical practice.
