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NRG CC001 showed that shaping whole-brain radiotherapy to spare the hippocampus, the seat of memory, reduces cognitive decline without any loss of tumour control.
NRG CC001 randomised 518 patients with brain metastases to whole-brain radiotherapy (30 Gy in ten fractions) with or without hippocampal avoidance, both with memantine. The risk of cognitive failure was lower with hippocampal avoidance (hazard ratio 0.74), with less deterioration in executive function at four months and in learning and memory at six months, and no difference in intracranial progression or survival (Brown and colleagues, Journal of Clinical Oncology 2020). Hippocampal avoidance with memantine is now the standard when whole-brain radiotherapy is needed.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Whole-brain radiotherapy (WBRT), Brain metastases (secondary brain tumours), Brain and spinal cord tumours (all types), Metastatic cancer (cancer that has spread) and the tag radiation-wave2.
Shares Organs at risk and dose constraints, NRG Oncology, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares Whole-brain radiotherapy (WBRT), Brain metastases (secondary brain tumours), Brain and spinal cord tumours (all types) and the tag radiation-wave2.
Shares Brain and spinal cord tumours (all types), IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares NRG Oncology, IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.
Shares IMRT / IGRT (modern external beam) and the tag radiation-wave2.