TY - JOUR
T1 - DEGRO practical guideline for central nervous system radiation necrosis part 2
T2 - treatment
AU - Expert Panel of the German Society of Radiation Oncology (DEGRO)
AU - Bernhardt, Denise
AU - König, Laila
AU - Grosu, Anca L.
AU - Rieken, Stefan
AU - Krieg, Sandro M.
AU - Wick, Wolfgang
AU - Wiestler, Benedikt
AU - Schmidt-Graf, Friederike
AU - Sahm, Felix
AU - Gempt, Jens
AU - Meyer, Bernhard
AU - Krause, Bernd J.
AU - Petersen, Cordula
AU - Fietkau, Rainer
AU - Thomas, Michael
AU - Giordano, Frank
AU - Wittig-Sauerwein, Andrea
AU - Debus, Jürgen
AU - Tabatabai, Ghazaleh
AU - Hau, Peter
AU - Steinbach, Joachim
AU - Combs, Stephanie E.
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/11
Y1 - 2022/11
N2 - Purpose: The Working Group for Neurooncology of the German Society for Radiation Oncology (DEGRO; AG NRO) in cooperation with members of the Neurooncological Working Group of the German Cancer Society (DKG-NOA) aimed to define a practical guideline for the diagnosis and treatment of radiation-induced necrosis (RN) of the central nervous system (CNS). Methods: Panel members of the DEGRO working group invited experts, participated in a series of conferences, supplemented their clinical experience, performed a literature review, and formulated recommendations for medical treatment of RN, including bevacizumab, in clinical routine. Conclusion: Diagnosis and treatment of RN requires multidisciplinary structures of care and defined processes. Diagnosis has to be made on an interdisciplinary level with the joint knowledge of a neuroradiologist, radiation oncologist, neurosurgeon, neuropathologist, and neurooncologist. If the diagnosis of blood–brain barrier disruptions (BBD) or RN is likely, treatment should be initiated depending on the symptoms, location, and dynamic of the lesion. Multiple treatment options are available (such as observation, surgery, steroids, and bevacizumab) and the optimal approach should be discussed in an interdisciplinary setting. In this practice guideline, we offer detailed treatment strategies for various scenarios.
AB - Purpose: The Working Group for Neurooncology of the German Society for Radiation Oncology (DEGRO; AG NRO) in cooperation with members of the Neurooncological Working Group of the German Cancer Society (DKG-NOA) aimed to define a practical guideline for the diagnosis and treatment of radiation-induced necrosis (RN) of the central nervous system (CNS). Methods: Panel members of the DEGRO working group invited experts, participated in a series of conferences, supplemented their clinical experience, performed a literature review, and formulated recommendations for medical treatment of RN, including bevacizumab, in clinical routine. Conclusion: Diagnosis and treatment of RN requires multidisciplinary structures of care and defined processes. Diagnosis has to be made on an interdisciplinary level with the joint knowledge of a neuroradiologist, radiation oncologist, neurosurgeon, neuropathologist, and neurooncologist. If the diagnosis of blood–brain barrier disruptions (BBD) or RN is likely, treatment should be initiated depending on the symptoms, location, and dynamic of the lesion. Multiple treatment options are available (such as observation, surgery, steroids, and bevacizumab) and the optimal approach should be discussed in an interdisciplinary setting. In this practice guideline, we offer detailed treatment strategies for various scenarios.
KW - Bevacizumab
KW - Blood–brain barrier disruptions
KW - Brain metastases
KW - Glioma
KW - Radiation necrosis
KW - Stereotactic radiotherapy
KW - Steroids
UR - http://www.scopus.com/inward/record.url?scp=85137293390&partnerID=8YFLogxK
U2 - 10.1007/s00066-022-01973-8
DO - 10.1007/s00066-022-01973-8
M3 - Review article
C2 - 36038670
AN - SCOPUS:85137293390
SN - 0179-7158
VL - 198
SP - 971
EP - 980
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 11
ER -