Targeted brain tumour radiotherapy to reduce the impact on learning and memory

Fast facts

• Official title: A randomized phase II trial of Hippocampal Sparing versus Conventional Whole Brain Radiotherapy after surgical resection or radiosurgery in favourable prognosis patients with 1-4 brain metastases (HIPPO)
• Lead researcher: Dr Gillian Whitfield
• Where: University of Manchester
• When: March 2014 – June 2017
• Cost: £40,649
• Research type: Adult, Metastases, Clinical Trial, Radiotherapy

Determining whether targeted radiotherapy avoiding the hippocampi in the brain reduces memory and learning difficulties associated with whole brain radiotherapy in patients whose cancer has spread to the brain (metastases).

Dr Gillian Whitfield and colleagues at the University of Manchester and the UCL Clinical Trials Unit are testing whether a more targeted approach to radiotherapy could reduce the memory and learning difficulties that can be associated with whole brain radiotherapy.

Radiotherapy used high energy rays to destroy cancer cells in the brain, but it also affects some normal cells. Whole Brain Radiotherapy (WBRT) is one of the treatment options for brain tumour patients whose tumours are difficult to remove with surgery, or where the tumour has spread to several different areas of the brain, or had regrown following previous treatment. In WBRT, radiation is given to the whole brain over a period of several weeks. This can destroy cells in the hippocampus, a region of the brain important for memory and learning. When a patient undergoes hippocampus sparing whole brain radiotherapy (HSWBRT), however, the hippocampus region of the brain is spared from radiation.

In this trial jointly funded by The Brain Tumour Charity and Cancer Research UK the researchers will compare memory and verbal reasoning in patients treated with standard whole brain radiotherapy compared with hippocampal sparing radiotherapy. They will also look at other factors including quality of life, tumour control and overall survival.

Positive results may mean it is possible to set up a larger trial to confirm findings and potentially establish HS-WBRT as the new standard treatment for patients with brain metastases.

Brain metastases account for an increasing proportion of brain tumours as treatments for other cancers improve and safer, more effective treatments are urgently needed.