ArticleCancers2021
Risk Factors for Radiation Necrosis in Patients Undergoing Cranial Stereotactic Radiosurgery.
Article in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 35 citations in OpenAlex.
- Multidisciplinary management of meningiomas in the era of precision oncology.Nature reviews. Clinical oncology · 2026Review
- Radionecrosis risk and local control after CyberKnifeRadiation oncology (London, England) · 2026Article
- A Challenging Differential Diagnosis Between Brain Radionecrosis and Recurrent Metastatic Disease, with Temporary Clinical/Radiological Response to Bevacizumab and Later Imaging Suspicious for Oligoprogression.Life (Basel, Switzerland) · 2026Article
- Radiation-Induced Neurodegeneration.Biomedicines · 2026Review
- Impact of stereotactic radiosurgery dose on local control and radiation necrosis in metastatic brain lesions: a comparative study.Frontiers in oncology · 2026Article
- Radiation Necrosis in Neuro-Oncology: Diagnostic Complexity and Precision Radiotherapy Strategies.Cancers · 2025Review
- Stereotactic Radiosurgery for Recurrent Meningioma: A Systematic Review of Risk Factors and Management Approaches.Cancers · 2025Review
- Effectiveness of Gamma Knife radiosurgery for recurrent glioblastoma: a 10-year retrospective analysis.Neurosurgical review · 2025Article
- Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care.Nature reviews. Clinical oncology · 2025Review
- Brain metastases from lung cancer: recent advances and novel therapeutic opportunities.Discover oncology · 2025Review
- Radiation-Induced Brain Injury: Mechanistic Insights and the Promise of Gut-Brain Axis Therapies.Brain sciences · 2024Review
- Radiomic Analysis of Treatment Effect for Patients with Radiation Necrosis Treated with Pentoxifylline and Vitamin E.Tomography (Ann Arbor, Mich.) · 2024Article
- Can low-dose intravenous bevacizumab be as effective as high-dose bevacizumab for cerebral radiation necrosis?Cancer science · 2024Article
- Adverse radiation effect versus tumor progression following stereotactic radiosurgery for brain metastases: Implications of radiologic uncertainty.Journal of neuro-oncology · 2024Article
- Stereotactic Radiosurgery for Women Older than 65 with Breast Cancer Brain Metastases.Cancers · 2023Article
- Risk Factors for Radiation Necrosis and Local Recurrence after Proton Beam Therapy for Skull Base Chordoma or Chondrosarcoma.Cancers · 2023Article
- Whole brain radiation therapy resulting in radionecrosis: a possible link with radiosensitising chemoimmunotherapy.BMJ case reports · 2023Article
- Tumor Location Impacts the Development of Radiation Necrosis in Benign Intracranial Tumors.Cancers · 2023Article
- Presence of Activated (Phosphorylated) STAT3 in Radiation Necrosis Following Stereotactic Radiosurgery for Brain Metastases.International journal of molecular sciences · 2023Article
- Narrative Review of Multidisciplinary Management of Central Nervous Involvement in Patients with HER2-Positive Metastatic Breast Cancer: Focus on Elderly Patients.Advances in therapy · 2023Review
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposesingle-staged stereotactic radiosurgery (SRS) is an established part of the multimodal treatment in neuro-oncology. Radiation necrosis after high-dose irradiation is a known complication, but there is a lack of evidence about the risk factors. The aim of this study was to evaluate possible risk factors for radiation necrosis in patients undergoing radiosurgery.
methodspatients treated with radiosurgery between January 2004 and November 2020 were retrospectively analyzed. The clinical data, imaging and medication were gathered from electronic patient records. The largest diameter of the tumors was measured using MRI scans in T1 weighted imaging with gadolinium and the edema in T2 weighted sequences. The diagnosis of a radiation necrosis was established analyzing imaging criteria combined with clinical course or pathologically confirmed by subsequent surgical intervention. Patients developing radiation necrosis detected after SRS were compared to patients without evidence of an overshooting irradiation reaction.
results388 patients were included retrospectively, 61 (15.7%) of whom developed a radiation necrosis. Median follow-up was 24 (6-62) months with a radiation necrosis after 8 (6-12) months. The most frequent tumors were metastases in 47.2% of the cases, followed by acoustic neuromas in 32.2% and meningiomas in 13.4%. Seventy-three (18.9%) patients already underwent one or more previous radiosurgical procedures for different lesions. The mean largest diameter of the tumors amounted to 16.3 mm (±6.1 mm). The median-80%-isodose administered was 16 (14-25) Gy. Of the radiation necroses, 25 (43.1%) required treatment, in 23 (39.7%) thereof, medical treatment was applied and in 2 (3.4%) cases, debulking surgery was performed. In this study, significantly more radiation necroses arose in patients with higher doses (HR 1.3 [CI 1.2; 1.5],
conclusionlarge diameter and high doses were reliable independent risk factors leading to more frequent radiation necroses, regardless of tumor type in patients undergoing radiosurgery. Alternative therapeutic procedures may be considered in lesions with large volume and an expected high radiation doses due to the increased risk of developing radiation necrosis.
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