الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Conventional whole brain radiotherapy is still the standard of care for treating patients with multiple brain metastasis, aiming for palliation of neurological deficits and improving quality of life, also it was noted that WBRT prolongs time for neurocognitive function (NCF) decline.
Still the best mean of treatment is surgical resection if amenable, but it is limited by the patient’s performance status, the location of the brain secondaries, and the multiplicity of brain metastasis.
Radiotherapy by itself can cause NCF decline, depending on several factors, usually occurring within one to four months after treatment, mainly noted in cognitive functions and memory affection.
The main site in the brain affected as a sequalae for WBRT, was assumed to be the hippocampus, which was attributed for the brain cognitive functions and memory function, hence avoidance the hippocampus was presumed to preserve the cognitive functions.
NCF was assessed by two tools the HVLT and OCLT , as a mean for measuring the cognitive functions and to be used as a mean for evaluating the NCF, by a score being measured before the treatment and after the treatment in both patients who received conventional WBRT and HA-WBRT.
We recruited 2 arms, each group comprised of 25 patients, of which they were diagnosed as cancer patients with brain metastasis , who were advised for WBRT, both were evaluated by using the 2 means both HVLT and OCLT prior to treatment and after treatment.
It was statistically significant for HA-WBRT arm in decreasing NCF following radiotherapy, being a safe and rapid technique, with betted disease outcome than in the conventional WBRT arm and with better preservation of cognitive functions.