SynthesisJournal of neuro-oncology2016
Treatment of pediatric cerebral radiation necrosis: a systematic review.
Synthesis in Journal of neuro-oncology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 36 citations in OpenAlex.
- Hyperbaric oxygen therapy for late radiation tissue injury.The Cochrane database of systematic reviews · 2023Pooled it
- East Asian multi-centre study on clinical long-term outcomes of postoperative proton beam therapy for localised paediatric intracranial ependymoma.Clinical and translational radiation oncology · 2026Article
- Radiation therapy increases long-term gonadotropin deficiency, hypothalamic-pituitary dysfunction, and brainstem necrosis in pediatric patients with brain tumor.Radiation oncology journal · 2026Article
- Corticosteroid use in pediatric neuro-oncology symptom management: A rapid review.Neuro-oncology practice · 2026Review
- Bevacizumab for the Management of Pediatric Radiation Necrosis: a Narrative Review.Current oncology reports · 2026Review
- Bevacizumab in Pediatric Neuro-Oncology.Current oncology (Toronto, Ont.) · 2025Review
- Analysis of brain necrosis and secondary cancers after proton beam therapy for pediatric intracranial tumors: a single-center retrospective study.Frontiers in oncology · 2025Article
- Article
- Brain metastases: An update on the multi-disciplinary approach of clinical management.Neuro-Chirurgie · 2022Review
- Relapsed Medulloblastoma in Pre-Irradiated Patients: Current Practice for Diagnostics and Treatment.Cancers · 2021Review
- Bevacizumab for pediatric radiation necrosis.Neuro-oncology practice · 2020Article
- Treatment of radiation-induced myelopathy with bevacizumab.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2020Article
- Bevacizumab in the treatment of radiation injury for children with central nervous system tumors.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2019Article
- Use of hyperbaric oxygen therapy in pediatric neuro-oncology: a single institutional experience.Journal of neuro-oncology · 2019Article
- Neuro-oncologists have spoken - the role of bevacizumab in the inpatient setting. A clinical and economic conundrum.Neuro-oncology practice · 2019Article
- Biopsy of enlarging lesions after stereotactic radiosurgery for brain metastases frequently reveals radiation necrosis.Neuro-oncology · 2017Article
- Does a Bevacizumab-based regime have a role in the treatment of children with diffuse intrinsic pontine glioma? A systematic review.Neuro-oncology advancesArticle
- Multidisciplinary patient-centered management of brain metastases and future directions.Neuro-oncology advancesReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Cerebral radiation necrosis (CRN) is a toxicity of radiation therapy that can result in significant, potentially life-threatening neurologic deficits. Treatment for CRN has included surgical resection, corticosteroids, hyperbaric oxygen therapy (HBOT), and bevacizumab, but no consensus approach has been identified. We reviewed the available literature to evaluate efficacy of treatment approaches. Using methods specified in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines when possible, we conducted searches of Ovid MEDLINE, Embase and Pubmed to identify studies reporting on outcomes for children (≤21 years old) with CRN. Eligible studies from 1990 to 2014 describing central nervous system (CNS) radiation necrosis with details of both treatment and outcomes were included. Eleven studies meeting criteria were identified. Of the nine studies with total patient denominators, 37 of 806 patients developed CRN (incidence = 4.6 %). Patients received treatment courses of steroids alone (n = 13), steroids with bevacizumab (n = 11) or HBOT (n = 12). Patients who failed to respond to steroids were more likely to be older than steroid-responsive patients (p = 0.009). With the exception of steroid-related adverse events, there was only one report of an adverse event (brainstem stroke) potentially attributable to intervention (bevacizumab). Those who received proton beam RT were both younger (p = 0.001) and had a shorter time to development of CRN (p = 0.079). The most common treatment following steroid initiation was addition of bevacizumab or HBOT, with good success and minimal toxicity. However, randomized controlled trials are needed to establish a definitive treatment algorithm that can be applied to children affected by CRN.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.