Mednet Logo

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.
Community PollStarted

What is the most common radiation treatment you use for brain metastasis

194 physicians have voted

Join Mednetto vote and see how they answered.

2 Answers
Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · University of New Mexico School of Medicine
Answered on

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:

  1. Radiosurgery is very easily administered & frequently free of toxicity.
  2. Systemic agents are showing improved efficacy in the brain.
  3. Surveillance MR imaging = lower incidence of ...

Join for free or sign in to see the full answer

Mednet Member
Mednet MemberInvited Expert
Radiation Oncology · Stony Brook University School of Medicine
Answered on

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.

Join for free or sign in to see the full answer