GuidelineStrahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]2022
DEGRO practical guideline for central nervous system radiation necrosis part 2: treatment.
Guideline in Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al], 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Resection of brain radionecrosis after stereotactic radiosurgery or radiotherapy: a meta-analysis.Neurosurgical review · 2026Pooled it
- Comparative analysis of bevacizumab and LITT for treating radiation necrosis in previously radiated CNS neoplasms: a systematic review and meta-analysis.Journal of neuro-oncology · 2024Pooled it
- Efficacy and toxicity of bimodal radiotherapy in WHO grade 2 meningiomas following subtotal resection with carbon ion boost: Prospective phase 2 MARCIE trial.Neuro-oncology · 2024Trial
- Reirradiation of recurrent brain tumors: a review by the ESTRO CNS Focus Group.Clinical and translational radiation oncology · 2027Review
- The threefold value of surgery in previously irradiated brain metastases.Journal of neuro-oncology · 2026Article
- Postoperative fractionated stereotactic radiotherapy for completely resected brain metastases with 25 Gy in five fractions: A single-center retrospective study.Clinical and translational radiation oncology · 2026Article
- Amide proton transfer-weighted (APTw) CEST MRI in clinical routine for single time point diagnosis of pseudoprogression in IDH-wildtype glioblastoma.Neuro-oncology · 2026Article
- Advances in the prevention and treatment of radiation-induced brain necrosis: a narrative review.Frontiers in oncology · 2026Review
- Reassessing the Management of Treatment-Induced Brain Necrosis in Metastatic Patients: Advancing Surgical Alternatives to Steroid Therapy.Neurosurgery practice · 2025Review
- Management outcomes for biopsy-proven radiation necrosis in patients with brain metastases in the era of immune-checkpoint blockade.Journal of neuro-oncology · 2025Article
- Reirradiation for recurrent glioblastoma: the significance of the residual tumor volume.Journal of neuro-oncology · 2025Article
- Stereotactic radiosurgery for patients with brain metastases: current principles, expanding indications and opportunities for multidisciplinary care.Nature reviews. Clinical oncology · 2025Review
- Article
- Study Protocol of a Prospective Phase 2 Study of Chlorophyllin for the Management of Brain Radionecrosis in Patients With Diffuse Glioma (CHROME).Cancer medicine · 2025Article
- Cerebral radiation necrosis successfully treated with high-dose bevacizumab.Respiratory medicine case reports · 2025Article
- The role of FET-PET in patient selection and response assessment for reirradiation in recurrent glioblastoma.Frontiers in oncology · 2025Review
- Resolving spatial response heterogeneity in glioblastoma.European journal of nuclear medicine and molecular imaging · 2024Article
- Article
- Cost-effectiveness analysis of bevacizumab for cerebral radiation necrosis treatment based on real-world utility value in China.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Clinical and radiological effects of Bevacizumab for the treatment of radionecrosis after stereotactic brain radiotherapy.BMC cancer · 2024Article
Corrections and comments
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Authors and funding
23 authors.
Funding
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Abstract
purposeThe Working Group for Neurooncology of the German Society for Radiation Oncology (DEGRO; AG NRO) in cooperation with members of the Neurooncological Working Group of the German Cancer Society (DKG-NOA) aimed to define a practical guideline for the diagnosis and treatment of radiation-induced necrosis (RN) of the central nervous system (CNS).
methodsPanel 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.
conclusionDiagnosis 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 neurooncologist. If the diagnosis of blood-brain barrier disruptions (BBD) or RN is likely, treatment should be initiated depending on the symptoms, location, and dynamic of the lesion. Multiple treatment options are available (such as observation, surgery, steroids, and bevacizumab) and the optimal approach should be discussed in an interdisciplinary setting. In this practice guideline, we offer detailed treatment strategies for various scenarios.
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