Abstract
Radiation treatment techniques for whole-brain radiation therapy (WBRT) have not changed significantly since development of the procedure. However, the recent development of novel techniques such as intensity-modulated radiation therapy (IMRT), volumetric-modulated arc therapy (VMAT) and helical tomotherapy, as well as an increasing body of evidence concerning neural stem cells (NSCs) have altered the conventional WBRT treatment paradigm. In this regard, hippocampus-sparing WBRT is a novel technique that aims to spare critical hippocampus regions without compromising tumour control. Published data on this new technique are limited to planning and feasibility studies; data on patient outcome are still lacking. However, several prospective trials to analyse the feasibility of this technique and to document clinical outcome in terms of reduced neurotoxicity are ongoing.
Zusammenfassung
Die Technik der Ganzhirnbestrahlung („whole-brain radiation therapy“, WBRT) hat sich seit der Entwicklung nicht wesentlich verändert. Allerdings stellten die Neuentwicklung von Techniken wie die intensitätsmodulierte Strahlentherapie (IMRT), die volumenmodulierte Arc-Therapie (VMAT) oder die helikale Tomotherapie sowie immer größeres Wissen über das neurale Stammzellkompartiment (NSCs) das herkömmliche Ganzhirn-Paradigma in Frage. Die hippocampusschonende Ganzhirnbestrahlung ist eine neuartige Technik, welche die kritische Region des Hippocampus schont, ohne die Tumorkontrolle zu gefährden. Über diese Technik gibt es bisher nur eine begrenzte Datenlage im Sinne von Planungs- und Machbarkeitsstudien. Klinische Daten bzgl. der Behandlungsergebnisse fehlen nach wie vor, aber einige prospektive Studien sind im Gange, um nicht nur die Machbarkeit zu belegen, sondern auch das klinische Outcome im Sinne einer verringerten Neurotoxizität nachzuweisen.
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Conflict of interest. F. Oskan, U. Ganswindt, S.B. Schwarz, F. Manapov, C.Belka and M. Niyazi state that there are no conflicts of interest.
The accompanying manuscript does not include studies on humans or animals.
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Oskan, F., Ganswindt, U., Schwarz, S. et al. Hippocampus sparing in whole-brain radiotherapy. Strahlenther Onkol 190, 337–341 (2014). https://doi.org/10.1007/s00066-013-0518-8
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DOI: https://doi.org/10.1007/s00066-013-0518-8