Neurocognitive Impact and Dose-Effect Relationship of Hippocampal Avoidance During Whole Brain Radiotherapy Plus Simultaneous Integrated Boost - A Prospective Follow-up Study
Brain Metastasis, Brain Metastases
About this trial
This is an interventional treatment trial for Brain Metastasis
Eligibility Criteria
Inclusion Criteria:
- Patients with pathologically-confirmed non-hematopoietic malignancy who are referred for therapeutic or prophylactic WBRT
- Good performance status no worse than Eastern Cooperative Group (ECOG) of 2 or a general status of Karnofsky Score (KPS) at least 70 %
- The number and extent of brain metastatic lesions should be no more than three metastatic foci with a greatest diameter no more than 3 cm
Exclusion Criteria:
- Patients with MRI-identified metastasis within 5 mm perihippocampally
- Patients with metastasis involving the brain stem
- Clinical suspicion of leptomeningeal spreading
- Patients with a solitary brain metastatic lesion which had been totally removed
- History of prior radiotherapy including stereotactic radiosurgery delivered to brain/head region for any reasons
Sites / Locations
- Chang Gung Memorial HospitalRecruiting
Arms of the Study
Arm 1
Experimental
Hippocampus-sparing WBRT plus SIB
All studied patients should undergo a computed tomography (CT) simulation scan encompassing the entire head region with 1.25-mm slice thickness using a thermoplastic mask for immobilization. To achieve conformal hippocampal sparing during the delivery of whole brain radiation (WBRT) and simultaneous integrated boost(s) (SIB), the technique of volumetric modulated arc therapy (VMAT) via Linac-based RapidArc®.In terms of dose prescription, a dose of 30 Gy in 12 fractions was prescribed to whole-brain planning target volume (PTV) containing the normal brain parenchyma; an simultaneous integrated boost up to 120 - 150% is attempted to irradiate the gross metastatic foci.