Giakoumettis Georgios, Gkantaifi Areti, Giakoumettis Dimitrios, Kouskouras Konstantinos, Siountas Anastasios, Bamidis Panagiotis, Papanastasiou Emmanouil
Laboratory of Medical Physics and Digital Innovation, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Laboratory of Medical Physics and Digital Innovation, American Hellenic Educational Progressive Association (AHEPA) University Hospital, Thessaloniki, GRC.
Cureus. 2025 Jun 14;17(6):e86007. doi: 10.7759/cureus.86007. eCollection 2025 Jun.
A standard practice in the treatment of patients with small-cell lung cancer (SCLC) is prophylactic cranial irradiation (PCI) to reduce the chance of brain metastases. However, whole brain radiation therapy (WBRT) has been associated with concerns about neurocognitive decline. This has led to the development of WBRT techniques with the simultaneous avoidance of the hippocampus (HA). This article reviews the existing literature on the incidence of hippocampal failure after HA PCI in patients with SCLC. The effort to protect the hippocampus aims to reduce side effects at a cognitive level, but, as reported in various studies, the results regarding safety and effectiveness are ambiguous. Some indicate a higher risk of recurrence in the hippocampal and perihippocampal regions, particularly in non-oligometastatic patients. Despite any concerns, many trials have shown that HA in PCI significantly reduces cognitive decline without compromising overall survival or control of brain metastases. The mixed results noted between studies indicate the necessity of clinical trials to elucidate the benefits and risks of PCI with simultaneous hippocampal protection in patients suffering from SCLC.
小细胞肺癌（SCLC）患者治疗的标准做法是进行预防性颅脑照射（PCI），以降低脑转移的几率。然而，全脑放射治疗（WBRT）一直与神经认知功能下降的问题相关。这促使了在全脑放射治疗技术中同时避免照射海马体（HA）的发展。本文回顾了关于SCLC患者接受HA PCI后脑海马体失败发生率的现有文献。保护海马体的努力旨在降低认知层面的副作用，但正如各项研究所报道的，关于安全性和有效性的结果并不明确。一些研究表明，海马体及海马体周围区域复发风险更高，尤其是在非寡转移患者中。尽管存在诸多担忧，但许多试验表明，PCI中的HA能显著降低认知功能下降，同时不影响总生存期或脑转移的控制。研究之间的这些混合结果表明，有必要开展临床试验，以阐明在SCLC患者中进行同时保护海马体的PCI的益处和风险。
