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Sans C, Dupin C, Huchet A, Branchard O, Nunes ML, Vendrely V, Loiseau H, Planchon C. [Prospective longitudinal study on the evolution of autobiographical memory in patients irradiated for benign skull base tumour]. Cancer Radiother 2024; 28:309-316. [PMID: 38918132 DOI: 10.1016/j.canrad.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 06/27/2024]
Abstract
PURPOSE Cranial irradiation can lead to long-term neurological complications, in particular memory disorders. The aim of this prospective study is to evaluate the impact of irradiation of benign skull base tumours located near the hippocampi on autobiographical memory. PATIENTS AND METHODS From 2016 to 2019, patients with cavernous sinus meningioma or pituitary adenoma treated with normofractionated irradiation were included. Patients underwent full neuropsychological assessment at baseline, 1year and 2years post-treatment. Neuropsychological tests were converted to Z-Score for comparability. RESULTS Twelve of the 19 patients included had a complete neuropsychological evaluation at 2years and were analysed. On the "TEMPau" test, no significant difference in autobiographical memory was found at 2years, regardless of the period of autobiographical memory. The mean hippocampal dose had no impact on the variation in autobiographical memory. There was no significant cognitive impairment in the other domains assessed, such as attention, anterograde memory, working memory and executive functions. Autobiographical memory was independent of these other cognitive domains, which justifies its specific study. CONCLUSION Radiotherapy to the skull base for a benign pathology does not lead to significant cognitive impairment. Longer follow-up would be needed to confirm these results.
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Affiliation(s)
- C Sans
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France
| | - C Dupin
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France; Inserm, U1312-BRIC, eq BioGO, université de Bordeaux, 33000 Bordeaux, France.
| | - A Huchet
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France
| | - O Branchard
- Service de neurochirurgie, hôpital Pellegrin, CHU de Bordeaux, 33600 Bordeaux, France
| | - M-L Nunes
- Service d'endocrinologie, hôpital Haut-Lévêque, CHU Bordeaux, 33600 Pessac, France
| | - V Vendrely
- Service de radiothérapie, hôpital Haut-Lévêque, CHU de Bordeaux, 33600 Pessac, France; Inserm, U1312-BRIC, eq BioGO, université de Bordeaux, 33000 Bordeaux, France
| | - H Loiseau
- Service de neurochirurgie, hôpital Pellegrin, CHU de Bordeaux, 33600 Bordeaux, France
| | - C Planchon
- Service de neurochirurgie, hôpital Pellegrin, CHU de Bordeaux, 33600 Bordeaux, France
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Chea M, Fezzani K, Jacob J, Cuttat M, Croisé M, Simon JM, Feuvret L, Valery CA, Maingon P, Benadjaoud MA, Jenny C. Dosimetric study between a single isocenter dynamic conformal arc therapy technique and Gamma Knife radiosurgery for multiple brain metastases treatment: impact of target volume geometrical characteristics. Radiat Oncol 2021; 16:45. [PMID: 33639959 PMCID: PMC7912819 DOI: 10.1186/s13014-021-01766-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/11/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose To compare linac-based mono-isocentric radiosurgery with Brainlab Elements Multiple Brain Mets (MBM) SRS and the Gamma Knife using a specific statistical method and to analyze the dosimetric impact of the target volume geometric characteristics. A dose fall-off analysis allowed to evaluate the Gradient Index relevancy for the dose spillage characterization. Material and methods Treatments were planned on twenty patients with three to nine brain metastases with MBM 2.0 and GammaPlan 11.0. Ninety-five metastases ranging from 0.02 to 9.61 cc were included. Paddick Index (PI), Gradient Index (GI), dose fall-off, volume of healthy brain receiving more than 12 Gy (V12Gy) and DVH were used for the plan comparison according to target volume, major axis diameter and Sphericity Index (SI). The multivariate regression approach allowed to analyze the impact of each geometric characteristic keeping all the others unchanged. A parallel study was led to evaluate the impact of the isodose line (IDL) prescription on the MBM plan quality. Results For mono-isocentric linac-based radiosurgery, the IDL around 70–75% was the best compromise found. For both techniques, the GI and the dose fall-off decreased with the target volume. In comparison, PI was slightly improved with MBM for targets < 1 cc or SI > 0.78. GI was improved with GP for targets < 2.5 cc. The V12Gy was higher with MBM for lesions > 0.4 cc or SI < 0.84 and exceeded 10 cc for targets > 5 cc against 6.5 cc with GP. The presence of OAR close to the PTV had no impact on the dose fall off values. The dose fall-off was higher for volumes < 3.8 cc with GP which had the sharpest dose fall-off in the infero-superior direction up to 30%/mm. The mean beam-on time was 94 min with GP against 13 min with MBM. Conclusions The dose fall-off and the V12Gy were more relevant indicators than the GI for the low dose spillage assessment. Both evaluated techniques have comparable plan qualities with a slightly improved selectivity with MBM for smaller lesions but with a healthy tissues sparing slightly favorable to GP at the expense of a considerably longer irradiation time. However, a higher healthy tissue exposure must be considered for large volumes in MBM plans.
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Affiliation(s)
- Michel Chea
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France.
| | - Karen Fezzani
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Julian Jacob
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Marguerite Cuttat
- Neurosurgery Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Mathilde Croisé
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Jean-Marc Simon
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Loïc Feuvret
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Charles-Ambroise Valery
- Neurosurgery Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, Paris, France
| | - Philippe Maingon
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
| | - Mohamed-Amine Benadjaoud
- PSE-SANTE/SERAMED, Radiation Protection and Nuclear Safety Institute, Fontenay aux Roses, France
| | - Catherine Jenny
- Radiation Oncology Department, Pitié-Salpêtrière Hospital, AP-HP Sorbonne University, 47-83 Boulevard de l'Hôpital, 75651, Paris Cedex 13, France
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Jacob J, Feuvret L, Mazeron JJ, Simon JM, Canova CH, Riet FG, Blais E, Jenny C, Maingon P. Radioterapia dei tumori cerebrali primitivi dell’adulto. Neurologia 2019. [DOI: 10.1016/s1634-7072(18)41587-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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