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Cerebral radiation necrosis: diagnostic challenge and clinical management

S.C. Eisele, J. Dietrich [REV NEUROL 2015;61:225-232] PMID: 26308844 DOI: https://doi.org/10.33588/rn.6105.2015118

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Volumen 61 | Number 05 | Nº of views of the article 41.503 | Nº of PDF downloads 879 | Article publication date 01/09/2015

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ABSTRACT

Cerebral radiation is an indispensable cornerstone in the treatment of many primary and metastatic brain tumors. However, besides its desired therapeutic effect on tumor cells, a significant proportion of patients will experience neurotoxic side effects as the consequence of radiotherapy. Radiation necrosis can result in progressive neurological symptoms and radiographic changes. To differentiate radiation necrosis from progressive tumor based on imaging can pose a diagnostic challenge because the MRI characteristics may be similar in both situations. Therefore, surgical biopsy and pathological confirmation is sometimes necessary to guide further management. Effective treatment options for cerebral radiation necrosis exist and should be offered to symptomatic patients. A better understanding of the cellular and molecular processes underlying the development of radiation necrosis is necessary to prevent and minimize radiation-associated morbidity and to improve treatment strategies. KeywordsBevacizumab Complications Glioma Management Radiation necrosis Review Steroids

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Cerebral radiation necrosis: diagnostic challenge and clinical management

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