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首页> 外文期刊>Radiation oncology >Why and how to spare the hippocampus during brain radiotherapy: the developing role of hippocampal avoidance in cranial radiotherapy
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Why and how to spare the hippocampus during brain radiotherapy: the developing role of hippocampal avoidance in cranial radiotherapy

机译：为什么和如何在脑放射治疗期间备用海马：海马避免在颅放射治疗中的发挥作用

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The goal of this review is to summarize the rationale for and feasibility of hippocampal sparing techniques during brain irradiation. Radiotherapy is the most effective non-surgical treatment of brain tumors and with the improvement in overall survival for these patients over the last few decades, there is an effort to minimize potential adverse effects leading to possible worsening in quality of life, especially worsening of neurocognitive function. The hippocampus and associated limbic system have long been known to be important in memory formation and pre-clinical models show loss of hippocampal stem cells with radiation as well as changes in architecture and function of mature neurons. Cognitive outcomes in clinical studies are beginning to provide evidence of cognitive effects associated with hippocampal dose and the cognitive benefits of hippocampal sparing. Numerous feasibility planning studies support the feasibility of using modern radiotherapy systems for hippocampal sparing during brain irradiation. Although results of the ongoing phase II and phase III studies are needed to confirm the benefit of hippocampal sparing brain radiotherapy on neurocognitive function, it is now technically and dosimetrically feasible to create hippocampal sparing treatment plans with appropriate irradiation of target volumes. The purpose of this review is to provide a brief overview of studies that provide a rationale for hippocampal avoidance and provide summary of published feasibility studies in order to help clinicians prepare for clinical usage of these complex and challenging techniques.
机译：本综述的目标是总结脑照射期间海马备件技术的理由和可行性。放射疗法是最近几十年脑肿瘤的最有效的非手术治疗脑肿瘤，随着这些患者的整体生存率的提高，努力尽量减少潜在的不利影响，导致生活质量可能恶化，特别是神经认知的恶化功能。海马和相关肢体系统已知在记忆形成和临床前模型中具有重要的临床模型，显示出辐射的海马干细胞的丧失以及成熟神经元的结构和功能的变化。临床研究中的认知结果开始提供与海马剂量相关的认知效果的证据和海马备件的认知益处。许多可行性计划研究支持在脑照射期间使用现代放疗系统使用现代放射疗法的可行性。虽然需要持续的阶段和III期研究的结果来证实海马备受脑放射对神经认知功能的益处，但现在在技术上和多重可行的情况下，创造具有适当照射目标体积的海马备受治疗计划。本综述的目的是简要概述研究海马避免的理由，并提供公布的可行性研究摘要，以帮助临床医生为这些复杂和具有挑战性的技术做好准备。

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