In Reply to Cihan

To the Editor: We welcome discussion on this important topic and thank Dr Cihan for her comments and useful further review of the literature on hippocampal damage. Moreover, we absolutely agree that radiation therapy is not the only cause of reduction in hippocampal volume. The purpose of our study (1, 2) was to determine whether radiation therapy in brain tumor patients was associated with hippocampal atrophy and whether there was, additionally, a dose-dependent effect. Indeed, we did find radiation dose–dependent atrophy in brain tumor patients.

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