Maragkoudakis E, Kouloulias V, Grenzelia M, Kougioumtzopoulou A, Zygogianni A, Ramfidis V, Charpidou A. Impact of Hippocampal Avoidance - Prophylactic Cranial Irradiation in Small Cell Lung Cancer Patients.
CANCER DIAGNOSIS & PROGNOSIS 2022;
2:279-284. [PMID:
35530654 PMCID:
PMC9066538 DOI:
10.21873/cdp.10105]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 03/14/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIM
Prophylactic cranial irradiation (PCI) is a well-established treatment of small cell lung cancer (SCLC) patients following response to initial chemoradiotherapy. The benefit of PCI does, however, come at the cost of cognitive decline. This has been attributed to radiation-induced toxicity at the hippocampus, a crucial anatomic area for cognition. Modern radiotherapy techniques allow dose reduction at the hippocampal region. In this review, the safety profile, effect on cognition, and changes on brain imaging modalities of hippocampal avoidance-PCI (HA-PCI) will be presented, aiming to identify a potential clinical rationale for SCLC patients.
MATERIALS AND METHODS
A systematic review of the literature was performed in Pubmed, Cochrane library databases and ClinicalTrials.gov with no past date limitations until 07/01/2022. Principles as outlined in the preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement were followed.
RESULTS
Eight studies published from 2015 to 2021 were included.
CONCLUSION
HA-PCI is safe, yet its effect on neurocognition and imaging remains unclear, as studies have shown contradictory results.
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