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Radiother Oncol. 2010 Dec;97(3):370-6. doi: 10.1016/j.radonc.2010.09.013. Epub 2010 Oct 20.

Why avoid the hippocampus? A comprehensive review.

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1
Department of Human Oncology, University of Wisconsin Comprehensive Cancer Center, Madison, WI 53792, USA. gondi@humonc.wisc.edu

Abstract

In this review article, we provide a detailed and comprehensive discussion of the rationale for using modern IMRT techniques to spare the subgranular zone of the hippocampus during cranial irradiation. We review the literature on neurocognitive effects of cranial irradiation; discuss clinical and preclinical data associating damage to neural progrenitor cells located in subgranular zone of the hippocampus with radiation-induced neurocognitive decline, specifically in terms of short-term memory formation and recall; and present a review of our pilot investigations into the feasibility and risks of sparing the subgranular zone of the hippocampus during whole-brain radiotherapy for brain metastases. We also introduce our phase II cooperative group clinical trial (RTOG 0933) designed to prospectively evaluate the postulated neurocognitive benefit of hippocampal subgranular zone sparing and scheduled to open in 2010.

PMID:
20970214
PMCID:
PMC2997490
DOI:
10.1016/j.radonc.2010.09.013
[Indexed for MEDLINE]
Free PMC Article
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