NRG CC001
NRG CC001 showed that shaping whole-brain radiotherapy to spare the hippocampus, the seat of memory, reduces cognitive decline without any loss of tumour control.
Overview
NRG CC001 randomised 518 patients with brain metastases to whole-brain radiotherapy (30 Gy in ten fractions) with or without hippocampal avoidance, both with memantine. The risk of cognitive failure was lower with hippocampal avoidance (hazard ratio 0.74), with less deterioration in executive function at four months and in learning and memory at six months, and no difference in intracranial progression or survival (Brown and colleagues, Journal of Clinical Oncology 2020). Hippocampal avoidance with memantine is now the standard when whole-brain radiotherapy is needed.
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