Study on Sparing the Hippocampus During Whole Brain Radiotherapy to Protect Memory in Patients with Brain Metastases

What this Trial Is About

Researchers are studying the use of hippocampal-sparing whole brain radiotherapy HS-WBRT in patients with brain metastases or those receiving prophylactic cranial irradiation mainly for small cell lung cancer. Whole brain radiotherapy WBRT is known to treat both visible and microscopic brain disease but can cause neurocognitive function NCF decline, especially affecting memory. This study aims to see if sparing the hippocampus during WBRT can preserve cognitive function better than traditional WBRT methods. Participants will receive HS-WBRT using volumetric modulated arc therapy VMAT with a Linac-based RapidArc device. Treatment involves a CT scan with a thermoplastic mask for head immobilization, followed by delivering 30 Gy in 12 fractions to the whole-brain planning target volume. This approach is used either after surgery to remove tumors or to treat limited brain metastases. The focus is on conformally avoiding the hippocampus to reduce radiation damage in this critical memory area. During the study, researchers will measure changes in verbal and non-verbal memory using the WMS III test at baseline and 4 months after starting HS-WBRT. Participants will also be monitored for overall survival and brain disease progression for up to 18 months. The study includes assessments such as brain MRI or CT scans and performance evaluations to track neurocognitive changes and treatment effects over time.

A Prospective Study of the Impact of Hippocampal Avoidance During Whole Brain Radiotherapy on Neurocognitive Function Decline