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Radiation Oncology • Neuro-Oncology
Would you perform unilateral or bilateral hippocampal avoidant whole brain RT in a patient with a prior SRS to a small hippocampal metastasis?
NRG-CC001 excluded a patient like this, but it seems that if the lesion in the HA region is treated, it would be reasonable.
Answer from: Radiation Oncologist at Academic Institution
I would recommend bilateral HA-WBRT and memantine in this situation.
The role for HA-WBRT is shrinking over time with a diminishing patient population between the expanding role of SRS for multiple brain mets and no role for cranial RT for poor prognosis patients with no/limited systemic ther...
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Answer from: Radiation Oncologist at Academic Institution
In short, I agree with Dr. @Brown. No viable, macroscopic disease in the hippocampus so reasonable to offer HA-WBRT. In the general/longer version:The tradeoff of HA-WBRT vs WBRT is the potential benefit of cognitive sparing via radiation dose reduction vs the risk of CNS failure in the h...