Facing pseudoprogression after radiotherapy in low grade gliomas

Carceller, Fernando; Mandeville, Henry; MacKinnon, Andrew D.; Saran, Frank

doi:10.21037/tcr.2017.03.46

Cited by 5 publications

(1 citation statement)

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“…Special considerations of radiation-induced CEL according to RT technique, typical localization, shape, and appearance : BBD after radiotherapy with association to the subventricular zone of the ventricular system can be seen frequently after photon and proton RT with doses that are below the TD5/5 in the marginal area of the RT volume. This may be due to the location of neural stem cells in the ventricular subependymal region [ 67 , 68 ] that are probably more sensitive to irradiation. In particle therapy, according to the beam arrangement, on the marginal treatment field where an increased RBE (and therefore higher dose with exceedance of the TD5/5) due to the distal edge of Bragg peak is expected, BBD occur more frequently [ 69 – 71 ].…”

Section: Resultsmentioning

confidence: 99%

DEGRO practical guideline for central nervous system radiation necrosis part 1: classification and a multistep approach for diagnosis

et al. 2022

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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.

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