Radiation necrosis following treatment of high grade glioma-a review of the literature and current understanding Journal Article
| Authors: | Siu, A.; Wind, J. J.; Iorgulescu, J. B.; Chan, T. A.; Yamada, Y.; Sherman, J. H. |
| Article Title: | Radiation necrosis following treatment of high grade glioma-a review of the literature and current understanding |
| Abstract: | Radiation therapy is an integral part of the standard treatment paradigm for malignant gliomas, with proven efficacy in randomized control trials. Radiation treatment is not without risk however, and radiation injury occurs in a certain proportion of patients. Difficulties in differentiating recurrence from radiation injury complicate the treatment course and can compromise care. These complexities are compounded by the recent distinction of two types of radiation injury: pseudoprogression and radiation necrosis, which are likely the result of radiation injury to the tumor and normal tissue, respectively. A thorough understanding of radiation-induced injury offers insights to guide further therapies. We detail the current knowledge of the mechanisms of radiation injury, along with potential targets for therapeutic intervention. Various diagnostic modalities are also described, in addition to the multiple options for treatment within the context of their pathophysiology and clinical efficacy. Radiation therapy is an integral part of the multidisciplinary management of gliomas, and the optimal diagnosis and management of radiation injury is paramount to improving patient outcomes. © 2011 Springer-Verlag. |
| Keywords: | disease course; histopathology; review; bevacizumab; nonhuman; drug targeting; pathophysiology; cancer radiotherapy; gadolinium; temozolomide; nuclear magnetic resonance imaging; positron emission tomography; cancer grading; diagnostic accuracy; radiation; diagnostic imaging; radiation injury; radiation response; contrast enhancement; glioblastoma; radiosurgery; fluorodeoxyglucose f 18; nuclear magnetic resonance spectroscopy; corticosteroid derivative; glia cell; clinical effectiveness; drug dose titration; drug sensitivity; diffusion weighted imaging; brain blood volume; perfusion weighted imaging; radiation necrosis; brain surgery; vascular disease; radiation protection; pseudoprogression; steroid therapy; radiobiology; diffusion tensor imaging; hyperbaric oxygen; isotope tracing |
| Journal Title: | Acta Neurochirurgica |
| Volume: | 154 |
| Issue: | 2 |
| ISSN: | 0001-6268 |
| Publisher: | Springer Wien |
| Date Published: | 2012-02-01 |
| Start Page: | 191 |
| End Page: | 201 |
| Language: | English |
| DOI: | 10.1007/s00701-011-1228-6 |
| PROVIDER: | scopus |
| PUBMED: | 22130634 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 March 2012" - "CODEN: ACNUA" - "Source: Scopus" |
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