ArticleRadiation oncology journal2020
Management of symptomatic radiation necrosis after stereotactic radiosurgery and clinical factors for treatment response.
Article in Radiation oncology journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Life-Threatening Radiation Necrosis After Complete Response to Pembrolizumab in a Patient With a Metastatic Silent PIT1 Pituitary Neuroendocrine Tumor (PitNET).Journal of immunotherapy (Hagerstown, Md. : 1997) · 2026Article
- Reassessing the Management of Treatment-Induced Brain Necrosis in Metastatic Patients: Advancing Surgical Alternatives to Steroid Therapy.Neurosurgery practice · 2025Review
- Review
- Bevacizumab for symptomatic cerebral radiation necrosis after radiation of high-grade glioma or brain metastases - when and for whom?Neuro-oncology practice · 2025Review
- Remarkable Resolution of Radiation Necrosis Post-Obsessive-Compulsive Disorder Radiosurgery With Boswellia Serrata: Case Report.Advances in radiation oncology · 2025Article
- Article
- Management of patients with brain metastases from NSCLC without a genetic driver alteration: upfront radiotherapy or immunotherapy?Therapeutic advances in medical oncology · 2023Review
- Systemic Therapy Type and Timing Effects on Radiation Necrosis Risk in HER2+ Breast Cancer Brain Metastases Patients Treated With Stereotactic Radiosurgery.Frontiers in oncology · 2022Article
- Surgical resection or bevacizumab for treatment of radiation necrosis-associated cerebral edema in patients with brain metastases: A single center experience.Neuro-oncology advancesArticle
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Authors and funding
11 authors.
Funding
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Abstract
purposeApproximately 10% of patients who received brain stereotactic radiosurgery (SRS) develop symptomatic radiation necrosis (RN). We sought to determine the effectiveness of treatment options for symptomatic RN, based on patient-reported outcomes. MATERIALS AND
methodsWe conducted a retrospective review of 217 patients with 414 brain metastases treated with SRS from 2009 to 2018 at our institution. Symptomatic RN was determined by appearance on serial magnetic resonance images (MRIs), MR spectroscopy, requirement of therapy, and development of new neurological complaints without evidence of disease progression. Therapeutic interventions for symptomatic RN included corticosteroids, bevacizumab and/or surgical resection. Patient-reported therapeutic outcomes were graded as complete response (CR), partial response (PR), and no response.
resultsTwenty-six patients experienced symptomatic RN after treatment of 50 separate lesions. The mean prescription dose was 22 Gy (range, 15 to 30 Gy) in 1 to 5 fractions (median, 1 fraction). Of the 12 patients managed with corticosteroids, 6 patients (50%) reported CR and 4 patients (33%) PR. Of the 6 patients managed with bevacizumab, 3 patients (50%) reported CR and 1 patient (18%) PR. Of the 8 patients treated with surgical resection, all reported CR (100%). Other than surgical resection, age ≥54 years (median, 54 years; range, 35 to 81 years) was associated with CR (odds ratio = 8.40; 95% confidence interval, 1.27-15.39; p = 0.027).
conclusionCorticosteroids and bevacizumab are commonly utilized treatment modalities with excellent response rate. Our results suggest that patient's age is associated with response rate and could help guide treatment decisions for unresectable symptomatic RN.
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