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Michelle Murphy



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    MA22 - New Therapeutics, Pathology, and Brain Metastases for Small Cell and Neuroendocrine Tumour (ID 925)

    • Event: WCLC 2018
    • Type: Mini Oral Abstract Session
    • Track: Small Cell Lung Cancer/NET
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 15:15 - 16:45, Room 206 BD
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      MA22.11 - Risk of Hippocampal Metastases in Small Cell Lung Cancer: Implications for Hippocampal Sparing Cranial Irradiation (ID 12791)

      16:25 - 16:30  |  Author(s): Michelle Murphy

      • Abstract
      • Presentation
      • Slides

      Background

      Prophylactic cranial irradiation (PCI) in patients with small cell lung cancer (SCLC) decreases the incidence of brain metastases (BMs) and can improve overall survival. However whole brain radiation therapy is associated with a decline in neurocognitive function. Hippocampal-sparing whole brain radiation therapy (HS-WBRT) aims to minimise damage to neural progenitor cells (NPCs) within the hippocampus and reduce the toxicity of PCI, although there may be an increased risk of treatment failure in the hippocampal region. The incidence of hippocampal metastases was investigated in patients with BMs from SCLC to evaluate the feasibility of HS-WBRT in this population.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      Patients with SCLC presenting between 2000 and 2016 with BMs at presentation or during their disease course without previous cranial irradiation were identified from a prospectively maintained database. Hippocampal metastases (HMs) were defined as metastases within the hippocampus and a 5-mm radial expansion (hippocampus avoidance zone, according to the Radiation Therapy Oncology Group 0933 atlas). The rate of hippocampal metastases and associated clinical features were analysed.

      4c3880bb027f159e801041b1021e88e8 Result

      One hundred and twenty eligible patients with a total of 754 brain metastases were identified. In 67 (55.8%) patients BMs were detected at diagnosis of SCLC and in 53 (44.2%) patients BMs developed later without previous PCI. The median number of metastases was 3, and 27 (22.5%) patients had a single BM. There were 22 (18.3%) patients with hippocampal metastases. A total of 23 (3.1%) metastases involved the hippocampal avoidance area. On logistic regression analysis, the number of brain metastases was an independent risk factor for HMs.

      8eea62084ca7e541d918e823422bd82e Conclusion

      The overall incidence of hippocampal metastases in our cohort of SCLC patients is high. As HS-WBRT may increase the risk of treatment failure in the spared region, prospective randomised trials are encouraged.

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