Department of Radiation Oncology at Carle Cancer Center, the University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL, USA.
Department of Radiation Oncology at Carle Cancer Center, the University of Illinois College of Medicine at Urbana-Champaign, Urbana, IL, USA.
Contemp Clin Trials. 2016 Mar;47:74-7. doi: 10.1016/j.cct.2015.12.013. Epub 2015 Dec 21.
Two recent clinical trials, phase III RTOG 0614 and phase II RTOG 0933, showed some effectiveness of Memantine and IMRT planning for hippocampus sparing, among patients receiving whole brain radiotherapy (WBRT) for brain metastases; however, their use in routine clinical practice is unknown.
A survey was sent to 1933 radiation oncologists in the US. Data collected included utilization of Memantine and hippocampus sparing, reasons for adoption and non-adoption, and demographic variables.
A total of 196 radiation oncologists responded to the survey, with 64% reporting using Memantine in almost none of the patients receiving WBRT for brain metastases, and only 11% considering Memantine for <10% of their patients. The most common reason for not using Memantine was a poor patient performance status, and limited life expectancy. Likewise, 56% of radiation oncologists would not change their clinical practice to include hippocampus sparing IMRT in patients receiving WBRT based on the results of RTOG 0933. Further validation of hippocampus sparing in a phase III trial was supported by 71% of radiation oncologists, whereas further exploration of Memantine for this purpose in a phase III trial was supported by 42%.
At this time, the majority of surveyed radiation oncologists in the US do not use Memantine, or IMRT planning for hippocampus sparing in patients receiving WBRT. Further validation of the hippocampus sparing concept in a phase III trial was supported, before adopting it in routine clinical practice.
两项最近的临床试验，III 期 RTOG 0614 和 II 期 RTOG 0933，显示了在接受全脑放疗（WBRT）治疗脑转移的患者中，使用美金刚和海马保护调强放疗（IMRT 计划）的一些有效性；然而，它们在常规临床实践中的应用尚不清楚。
向美国的 1933 名放射肿瘤学家发送了一份调查。收集的数据包括美金刚和海马保护的使用情况、采用和不采用的原因，以及人口统计学变量。
共有 196 名放射肿瘤学家对调查做出了回应，其中 64%的人报告说，在接受 WBRT 治疗脑转移的患者中，几乎没有使用美金刚，只有 11%的人考虑将美金刚用于不到 10%的患者。不使用美金刚的最常见原因是患者的身体状况不佳，预期寿命有限。同样，基于 RTOG 0933 的结果，56%的放射肿瘤学家不会改变他们的临床实践，在接受 WBRT 的患者中包括海马保护调强放疗。71%的放射肿瘤学家支持进一步验证 III 期试验中海马保护的有效性，而 42%的放射肿瘤学家支持在 III 期试验中进一步探索美金刚在这方面的用途。
目前，美国大多数接受调查的放射肿瘤学家在接受 WBRT 的患者中不使用美金刚或海马保护调强放疗。在将其应用于常规临床实践之前，需要进一步验证 III 期试验中海马保护的概念。
