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Topics:
Radiation Oncology • Palliation
Should hippocampal-avoidance WBRT be the default option for WBRT?
The idea would be to appropriately cover gross disease/lesions in/around the hippocampus, but then spare the rest of the hippocampus, with the rationale being that "partial hippocampal sparing" is still better than conventional WBRT with respect to neurocognitive decline, and recurrences within the hippocampus can be salvaged with SRS.
Answer from: Radiation Oncologist at Academic Institution
I think this is a difficult question to answer as a lot depends on the particulars. Here's a list of some of those issues:
Radiosurgery is very easily administered & frequently free of toxicity.
Systemic agents are showing improved efficacy in the brain.
Surveillance MR imaging = lower incide...
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Answer from: Radiation Oncologist at Academic Institution
I use hippocampal avoidance whenever possible. The best strategy to avoid/prevent radiation complications is not to use it. In the same concept, minimizing the dose to any normal structures or ALARA should always be exercised.