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Avoiding specific region of brain during whole-brain radiotherapy prevents memory loss
Date:9/23/2013

Atlanta, September 23, 2013Limiting the amount of radiation absorbed in the hippocampal portion of the brain during whole-brain radiotherapy (WBRT) for brain metastases preserves memory function in patients for up to six months after treatment, according to research presented today at the American Society for Radiation Oncology's (ASTRO's) 55th Annual Meeting.

The single-arm, phase II study was a multi-institutional, international clinical trial in the U.S. and Canada, conducted through the Radiation Therapy Oncology Group (RTOG). Researchers compared the study group to a historical control group of patients who had received WBRT without hippocampal avoidance in the PCI-P-120-9801 phase III trial (Li 2007).

This study enrolled 113 adult patients from 2011 through 2013 who had a measurable brain metastasis outside a 5-mm margin around the hippocampus. Of those patients, 100 were analyzable and 76 percent were categorized as recursive partitioning analysis (RPA) class II. All patients received hippocampal avoidance whole-brain radiotherapy (HA-WBRT) to 30 Gy in 10 fractions. In all analyzable patients, the dose received by the entirety of the hippocampus did not exceed 10 Gy, and the maximum dose did not exceed 17 Gy. Patients were assessed using the Hopkins Verbal Learning Test - Delayed Recall (HVLT-DR), the HVLT - Recall (HVLT-R) and the HVLT - Immediate Recognition (HVLT-IR) at baseline and post-treatment at two-, four- and six-month intervals. The primary endpoint of the trial was the HVLT-DR at four months.

Results showed that the 42 patients who were analyzable at four months post-RT had a seven percent decline in HVLT-DR from baseline to four months (95 percent confidence interval (CI): -4.7 percent to 18.7 percent). This is statistically significant when compared to the historical control group (p=0.0003), which demonstrated a 30 percent decline in HVLT-DR at four months. Six months after treatment, the 29 analyzable patient
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Contact: Michelle Kirkwood
michellek@astro.org
703-286-1600
American Society for Radiation Oncology
Source:Eurekalert

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