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Radiation Oncology
Published in: Radiation Oncology 1/2019

Open Access 01-12-2019 | Metastasis | Research

Prevalence of metastases within the hypothalamic-pituitary area in patients with brain metastases

Authors: Stefan Janssen, Preena Mehta, Tobias Bartscht, Sebastian M. Schmid, Fabian B. Fahlbusch, Dirk Rades

Published in: Radiation Oncology | Issue 1/2019

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Abstract

Aim

To quantify the prevalence of brain metastases involving the hypothalamic-pituitary (HT-P) area.

Introduction

Cognitive impairment and fatigue are common side effects of whole brain irradiation (WBI) comprising the quality of life (QoL) for survivors. While the former is related to radiation-induced hippocampal injury, the latter could be secondary to hormonal disbalance as a consequence of radiation of the HT-P area. Thus, sparing both regions from higher irradiation doses could reduce these sequelae.

Methods

T1 contrast medium enhanced magnetic resonance imaging (MRI) scans of 865 patients with brain metastases (4,280 metastases) were reviewed. HT-P area was individually contoured with a margin of 5 mm in order to evaluate the prevalence of brain metastases in this region.

Results

Involvement of the hypothalamic region was found in 26 patients (involvement rate of 3% for patients and 1% for metastases), involvement of the pituitary gland in 9 patients (1% for patients and < 1% for metastases). Binary logistical regression analysis revealed the presence of > 10 brain metastases as the only factor associated with hypothalamic involvement while no distinct factor was associated with an involvement of the pituitary gland.

Conclusion

The low prevalence of metastases within the HT-P area in patients with brain metastases calls for further studies examining whether sparing of this region might improve patients QoL.
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Metadata
Title
Prevalence of metastases within the hypothalamic-pituitary area in patients with brain metastases
Authors
Stefan Janssen
Preena Mehta
Tobias Bartscht
Sebastian M. Schmid
Fabian B. Fahlbusch
Dirk Rades
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2019
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-019-1337-6

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