Would you offer hippocampal sparing whole brain radiation for patients with brain metastases due to ES-SCLC?

Would you consider this if the patient does not appear to have hippocampal involvement? Or is the risk of subsequently developing hippocampal metastases too high?

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Do you routinely use hippocampal avoidance when treating ES-SCLC?

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3 Answers

Mednet Member

Radiation Oncology · Karmanos Cancer Institute - McLaren Proton Therapy Center

Answered on

Until we have built-in auto-segmentation, I find the RTOG contouring atlas very helpful for manual contouring of the hippocampus.

I tend to use the lateral ventricle as my main landmark, and look for the circle of gray matter located medial to it. Once I've drawn a hippocampus, I'll look at it in th...

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Radiation Oncology · Northwestern Medicine Cancer Center Warrenville

Answered on

Thank you to theMednet for the opportunity to address this important question. This reply was generated in collaboration with Dr. @Dr. First Last and Dr. @Dr. First Last.

We would recommend hippocampal avoidance (HA) using IMRT during WBRT for patients with brain metastases from small cell lung cance...

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Mednet Member

Radiation Oncology · WellSpan Good Samaritan Hospital

Answered on

I would love to use that, but I trained many eons ago, and don't feel confident that I can accurately delineate the hippocampus. I don't have neuroradiology available, and also don't have easy access to radiology for assistance.

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