TY - JOUR
T1 - DEGRO practical guideline for central nervous system radiation necrosis part 1
T2 - classification and a multistep approach for diagnosis
AU - Expert Panel of the German Society of Radiation Oncology (DEGRO)
AU - Bernhardt, Denise
AU - König, Laila
AU - Grosu, Anca
AU - Wiestler, Benedikt
AU - Rieken, Stefan
AU - Wick, Wolfgang
AU - Gempt, Jens
AU - Krieg, Sandro M.
AU - Schmidt-Graf, Friederike
AU - Sahm, Felix
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 - 2022/10
Y1 - 2022/10
N2 - Purpose: The Working Group for Neuro-Oncology of the German Society for Radiation Oncology in cooperation with members of the Neuro-Oncology Working Group of the German Cancer Society 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 neuro-oncologist. A multistep approach as an opportunity to review as many characteristics as possible to improve diagnostic confidence is recommended. Additional information about radiotherapy (RT) techniques is crucial for the diagnosis of RN. Misdiagnosis of untreated and progressive RN can lead to severe neurological deficits. In this practice guideline, we propose a detailed nomenclature of treatment-related changes and a multistep approach for their diagnosis.
AB - Purpose: The Working Group for Neuro-Oncology of the German Society for Radiation Oncology in cooperation with members of the Neuro-Oncology Working Group of the German Cancer Society 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 neuro-oncologist. A multistep approach as an opportunity to review as many characteristics as possible to improve diagnostic confidence is recommended. Additional information about radiotherapy (RT) techniques is crucial for the diagnosis of RN. Misdiagnosis of untreated and progressive RN can lead to severe neurological deficits. In this practice guideline, we propose a detailed nomenclature of treatment-related changes and a multistep approach for their diagnosis.
KW - Bevacizumab
KW - Brain metastases
KW - Glioma
KW - Radioation necrosis
KW - Reirradiation
UR - http://www.scopus.com/inward/record.url?scp=85137299106&partnerID=8YFLogxK
U2 - 10.1007/s00066-022-01994-3
DO - 10.1007/s00066-022-01994-3
M3 - Review article
C2 - 36038669
AN - SCOPUS:85137299106
SN - 0179-7158
VL - 198
SP - 873
EP - 883
JO - Strahlentherapie und Onkologie
JF - Strahlentherapie und Onkologie
IS - 10
ER -