Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio; Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio.
Int J Radiat Oncol Biol Phys. 2013 Nov 1;87(3):449-57. doi: 10.1016/j.ijrobp.2013.05.015. Epub 2013 Jun 19.
The incidence of radiation necrosis has increased secondary to greater use of combined modality therapy for brain tumors and stereotactic radiosurgery. Given that its characteristics on standard imaging are no different that tumor recurrence, it is difficult to diagnose without use of more sophisticated imaging and nuclear medicine scans, although the accuracy of such scans is controversial. Historically, treatment had been limited to steroids, hyperbaric oxygen, anticoagulants, and surgical resection. A recent prospective randomized study has confirmed the efficacy of bevacizumab in treating radiation necrosis. Novel therapies include using focused interstitial laser thermal therapy. This article will review the diagnosis and treatment of radiation necrosis.
由于脑肿瘤的联合治疗模式和立体定向放射外科的广泛应用，放射性坏死的发生率有所增加。由于其在标准影像学上的特征与肿瘤复发没有区别，因此如果不使用更复杂的影像学和核医学扫描，很难进行诊断，尽管这些扫描的准确性存在争议。历史上，治疗方法仅限于类固醇、高压氧、抗凝剂和手术切除。最近的一项前瞻性随机研究证实了贝伐单抗治疗放射性坏死的疗效。新的治疗方法包括使用聚焦间质激光热疗。本文将回顾放射性坏死的诊断和治疗。
