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When whole-brain radiotherapy is needed, shaping the beams to spare the hippocampus and adding memantine reduced the memory and thinking decline that the treatment causes, with no loss of tumour control.
Phase 3 trial of 518 patients with brain metastases randomised to whole-brain radiotherapy with memantine, with or without hippocampal avoidance using intensity-modulated techniques.
Cognitive failure was less frequent with hippocampal avoidance (hazard ratio 0.74), driven by less decline in executive function and memory, with no difference in overall survival, intracranial progression or toxicity.
Where whole-brain radiotherapy is still chosen, for many metastases or leptomeningeal disease, hippocampal avoidance with memantine is the recommended technique.
Shares Paul D. Brown, Brain metastases (secondary brain tumours).
Shares Paul D. Brown, Brain metastases (secondary brain tumours).
Shares NRG CC001, Brain metastases (secondary brain tumours).
Shares NRG CC001, Brain metastases (secondary brain tumours).