Evaluation of hippocampus-sparing VMAT versus conventional VMAT in locally advanced nasopharyngeal carcinoma: a dosimetric and biological analysis

This retrospective dosimetric comparison demonstrates the feasibility of the hippocampus-sparing technique in patients with locally advanced nasopharmenyngeal carcinoma. Our analysis indicates that HS-VMAT plans can achieve significant reductions in key hippocampal dose parameters, such as Dmax, Dmean, and D40%, while simultaneously maintaining adequate target coverage and adhering to dose constraints for other organs at risk. Supported by both dosimetric and biological (NTCP) analyses, these findings suggest a significantly lower predicted probability of hippocampus-related complications with the HS-VMAT approach. Therefore, our results support HS-VMAT as a theoretically feasible and clinically valuable strategy, with potential significance for preserving the neurocognitive function of patients with locally advanced NPC.