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. 2020 Aug;64(4):586-590.
doi: 10.1111/1754-9485.13079. Epub 2020 Jul 5.

Incidence of hippocampal metastases in non-small-cell lung cancer

Sophia Ly  1 , Margot Lehman  1 , Howard Liu  1 , Craig Hukins  2 , Michelle Murphy  2 , Margaret Dauth  2 , Matthew S Devine  3 , Gang Tao Mai  1   4
Affiliations

Incidence of hippocampal metastases in non-small-cell lung cancer

Sophia Ly et al. J Med Imaging Radiat Oncol. 2020 Aug.

Abstract

Objectives: Patients with locally advanced non-small-cell lung cancer (LA-NSCLC) develop brain metastases in 25-50% of cases during the course of their disease. Data on the incidence of metastases occurring in the hippocampus/perihippocampal zones are limited. This is important when considering hippocampal-sparing brain radiation (HS-BR), a method that could potentially reduce the neurocognitive impact of such treatment. The aim of this study was to assess the incidence of hippocampal/perihippocampal metastases in a cohort of patients with advanced NSCLC treated at our institution.

Methods: This retrospective cohort study included NSCLC patients discussed at our institutional lung cancer multidisciplinary meeting between 2000 and 2016. MRI and contrast-enhanced CT (ceCT) brain images were reviewed to assess the incidence of hippocampal/perihippocampal metastases including metastases within the hippocampal subgranular zone and a 5 mm margin (hippocampal avoidance region) defined as per the RTOG 0933 study.

Results: Of 2146 patients reviewed, 357 (16.6%) had brain metastases. A total of 335 patients had available MRI/ceCT brain images for review. Thirty (9%) patients had brain metastases in the hippocampal avoidance region, 8 (2.4%) with hippocampal metastases and 22 (6.6%) with perihippocampal metastases. Univariate analyses did not show an association between developing metastases in the hippocampal avoidance region and age (P = 0.75), gender (P = 0.91) and tumour type (P = 0.298).

Conclusion: The incidence of metastases in the hippocampal avoidance region in our large cohort of patients was 9%. With low rates of metastases in this region, HS-BR can be considered a feasible option in the management of patients with advanced NSCLC.

Keywords: brain metastases; hippocampus; non-small-cell lung cancer.

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