Hippocampal avoidance prophylactic cranial irradiation (HA-PCI) for small cell lung cancer better preserves white matter networks compared to conventional PCI.

Background: Hippocampal avoidance during prophylactic cranial irradiation (HA-PCI) is proposed to reduce neurocognitive decline, while preserving the benefits of PCI. We evaluated whether (HA-)PCI induces changes in white matter (WM) microstructure and whether sparing the hippocampus has an impact on preserving brain network topology. Additionally, we evaluated associations between topological metrics with hippocampal volume and neuropsychological outcomes.