Neurocognitive Outcomes for Patients With Brain Metastasis in the Modern Era: Benefit of Treatment With Hippocampal Avoidance Whole-Brain Radiotherapy Plus Memantine
Mené sur 518 patients présentant des métastases cérébrales (durée médiane de suivi : 7,9 mois), cet essai de phase III évalue, du point de vue de la préservation de la fonction cognitive, de la survie sans progression intracrânienne, de la survie globale et des symptômes rapportés par les patients, et la toxicité d'une radiothérapie de l'ensemble du cerveau épargnant l'hippocampe en combinaison avec la mémantine
Whole-brain radiotherapy (WBRT) has been the cornerstone treatment of patients with multiple brain metastases since its introduction in the 1950s.1 Today, it remains one of the most commonly delivered oncologic treatments, with > 200,000 patients per year receiving this treatment in the United States.2 Historically, the prognosis for these patients was generally poor, with survival measured in weeks to months.3,4 Despite this, the main utility of WBRT is in its ability to palliate neurologic symptoms, improve neurologic death rates, and reduce intracranial failure.5,6 In spite of these benefits, the toxicity of WBRT is readily apparent, including fatigue, alopecia, nausea, and cognitive decline.
Journal of Clinical Oncology , éditorial en libre accès, 2019