Author of

• 17341

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  MA11 - Novel Approaches in SCLC and Neuroendocrine Tumors (ID 391)

  • Event: WCLC 2016
  • Type: Mini Oral Session
  • Track: SCLC/Neuroendocrine Tumors
  • Presentations: 1
  • Moderators:P. Lara, A. Mohn-Staudner
  • Coordinates: 12/06/2016, 14:20 - 15:50, Strauss 3

  • 17352

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    MA11.11 - Is Hippocampal Avoidance during Whole Brain Radiotherapy Risky for Small Cell Lung Cancer Patients? (ID 3735)

    15:32 - 15:38  |  Author(s): O. Oztekin
    • Abstract
    • Presentation
    • Slides

    Background:
    Hippocampal avoidance (HA) during whole brain radiotherapy (WBRT) is performed to prevent neural stem-cell injury causing decreased neurocognitive function. Nevertheless, the estimated risk for metastases in HA area in small cell lung cancer (SCLC) patients is unknown. The current study aimed to characterize the metastatic distribution within the brain relative to the hippocampus and estimate the incidence of hippocampal metastasis in SCLC patients and also identify clinical and radiographic variables that may be associated with the presence of metastases within the HA area.
    
    Methods:
    SCLC patients treated with WBRT between January 2010 and December 2015 were reviewed. T1-wighted, post-contrast axial MRI (1.5 or 3 Tesla) images obtained just before therapeutic cranial irradiation were retrieved and reviewed for each patient. The HA area was generated by expanding the hippocampal contour by 5 mm volumetrically to account for necessary dose fall-off between the hippocampus (HP) and the whole brain planning target volume. Metastatic lesions within HP or HA area were defined as HP metastasis. HP metastasis rate was evaluated and characteristics of patients with HP metastasis were analyzed and compared to patients without HP metastasis.
    
    Results:
    54 patients evaluated with cranial MRI were enrolled. HP metastasis rate was 32% (17 patients). 4.4% of all metastases involved the HP and HA area (2.2% of metastases each) Figure 1. The most common location of metastasis was frontal lobe followed by cerebellum and temporal lobe. Having diabetes mellitus (OR: 12.1, 95% CI: 1.1-137.4, p=0.045) and being younger than 65 years of age (OR: 4.8, 95% CI: 1-23.2, p=0.049) were found to be independent risk factors for HP metastasis.
    
    
    
    Conclusion:
    HP metastasis might be more common in SCLC patients. Reducing the dose to the HP by HA-WBRT plan in SCLC may be risky for the development of HP metastasis compared with other malignant solid tumors.
    
    

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