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Title: Challenges With the Diagnosis and Treatment of Cerebral Radiation Necrosis

The incidence of radiation necrosis has increased secondary to greater use of combined modality therapy for brain tumors and stereotactic radiosurgery. Given that its characteristics on standard imaging are no different that tumor recurrence, it is difficult to diagnose without use of more sophisticated imaging and nuclear medicine scans, although the accuracy of such scans is controversial. Historically, treatment had been limited to steroids, hyperbaric oxygen, anticoagulants, and surgical resection. A recent prospective randomized study has confirmed the efficacy of bevacizumab in treating radiation necrosis. Novel therapies include using focused interstitial laser thermal therapy. This article will review the diagnosis and treatment of radiation necrosis.
Authors:
 [1] ;  [2] ;  [3] ;  [2] ;  [4] ;  [2] ;  [5] ;  [2] ;  [1] ;  [2] ;  [1] ;  [6] ;  [1] ;  [2]
  1. Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio (United States)
  2. (United States)
  3. Department of Medical Oncology, Cleveland Clinic, Cleveland, Ohio (United States)
  4. Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio (United States)
  5. Department of Neurology, Cleveland Clinic, Cleveland, Ohio (United States)
  6. Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)
Publication Date:
OSTI Identifier:
22267904
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 87; Journal Issue: 3; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ACCURACY; ANTICOAGULANTS; BRAIN; DIAGNOSIS; NECROSIS; NEOPLASMS; OXYGEN; RADIOTHERAPY; SURGERY