PDF(Pubmed)
Abstract：
BACKGROUND: Brain metastasis is a major concern, and may occur in roughly 50% of patients during the clinical course of small cell lung cancer (SCLC). Because prophylactic cranial irradiation reduces the incidence of brain metastases and improves overall survival, prophylactic cranial irradiation is recommended for SCLC patients without distant metastases or an extensive stage and have responded well to systemic therapy. Hippocampal-avoidance whole-brain radiotherapy (HA-WBRT) is preferred to preserve hippocampal function while minimizing negative cognitive effects.
METHODS: Reducing the dose delivered to the hippocampus below the therapeutic brain dose may increase the risk of hippocampal progression; thus, HA-WBRT may be associated with a risk of perihippocampal recurrence.
METHODS: Three patients with SCLC received HA-WBRT and developed intracranial failure during clinical follow-up; 3 relapsed with intracranial failure in the perihippocampal region after 12, 13, and 7 months, respectively.
RESULTS: Compared to the therapeutic brain dose of cases and the underdose region around the HA region, we matched MRI scans of intracranial failure and previous planning scans of simulation and found a deviation of the underdosed region within the perihippocampal failure of approximately 55% to 63%.
CONCLUSIONS: Perihippocampal failure is a rare clinical outcome in SCLC patients following HA-WBRT. Perihippocampal failure could be caused by an underdose of radiation or by the aggressiveness of the cancer itself. More research into this topic is encouraged.
METHODS: Reducing the dose delivered to the hippocampus below the therapeutic brain dose may increase the risk of hippocampal progression; thus, HA-WBRT may be associated with a risk of perihippocampal recurrence.
METHODS: Three patients with SCLC received HA-WBRT and developed intracranial failure during clinical follow-up; 3 relapsed with intracranial failure in the perihippocampal region after 12, 13, and 7 months, respectively.
RESULTS: Compared to the therapeutic brain dose of cases and the underdose region around the HA region, we matched MRI scans of intracranial failure and previous planning scans of simulation and found a deviation of the underdosed region within the perihippocampal failure of approximately 55% to 63%.
CONCLUSIONS: Perihippocampal failure is a rare clinical outcome in SCLC patients following HA-WBRT. Perihippocampal failure could be caused by an underdose of radiation or by the aggressiveness of the cancer itself. More research into this topic is encouraged.
摘要：
背景：脑转移是一个主要问题，在小细胞肺癌（SCLC）的临床过程中，约有50％的患者可能发生。因为预防性颅骨照射降低了脑转移的发生率并提高了总体生存率，对于无远处转移或广泛分期且对全身治疗反应良好的SCLC患者,建议进行预防性颅骨照射.避免海马全脑放疗（HA-WBRT）是优选的，以保持海马功能，同时最大程度地减少负面认知影响。
方法：将传递给海马的剂量减少到低于治疗脑剂量可能会增加海马进展的风险；因此，HA-WBRT可能与海马周围复发的风险相关。
方法：3例SCLC患者接受HA-WBRT并在临床随访期间出现颅内衰竭；3例在12、13和7个月后复发并在海马周围区域出现颅内衰竭，分别。
结果：与病例的脑治疗剂量和HA区域周围的剂量不足区域相比，我们将颅内衰竭的MRI扫描与先前的模拟计划扫描进行了匹配,发现海马周围衰竭内剂量不足区域的偏差约为55%~63%.
结论：在HA-WBRT后SCLC患者中，海马周围衰竭是一种罕见的临床结局。海马周围衰竭可能是由于辐射剂量不足或癌症本身的侵袭性引起的。鼓励对该主题进行更多研究。
方法：将传递给海马的剂量减少到低于治疗脑剂量可能会增加海马进展的风险；因此，HA-WBRT可能与海马周围复发的风险相关。
方法：3例SCLC患者接受HA-WBRT并在临床随访期间出现颅内衰竭；3例在12、13和7个月后复发并在海马周围区域出现颅内衰竭，分别。
结果：与病例的脑治疗剂量和HA区域周围的剂量不足区域相比，我们将颅内衰竭的MRI扫描与先前的模拟计划扫描进行了匹配,发现海马周围衰竭内剂量不足区域的偏差约为55%~63%.
结论：在HA-WBRT后SCLC患者中，海马周围衰竭是一种罕见的临床结局。海马周围衰竭可能是由于辐射剂量不足或癌症本身的侵袭性引起的。鼓励对该主题进行更多研究。
