Klinik und Poliklinik für Radioonkologie und Strahlentherapie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany.
Partner Sites Munich, Freiburg and Heidelberg, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Heidelberg, Germany.
Strahlenther Onkol. 2022 Oct;198(10):873-883. doi: 10.1007/s00066-022-01994-3. Epub 2022 Aug 29.
The Working Group for Neuro-Oncology of the German Society for Radiation Oncology in cooperation with members of the Neuro-Oncology Working Group of the German Cancer Society aimed to define a practical guideline for the diagnosis and treatment of radiation-induced necrosis (RN) of the central nervous system (CNS).
Panel 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.
Diagnosis 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 neuro-oncologist. A multistep approach as an opportunity to review as many characteristics as possible to improve diagnostic confidence is recommended. Additional information about radiotherapy (RT) techniques is crucial for the diagnosis of RN. Misdiagnosis of untreated and progressive RN can lead to severe neurological deficits. In this practice guideline, we propose a detailed nomenclature of treatment-related changes and a multistep approach for their diagnosis.
德国放射肿瘤学会神经肿瘤学工作组与德国癌症学会神经肿瘤学工作组的成员合作，旨在为中枢神经系统（CNS）放射性坏死（RN）的诊断和治疗制定实用指南。
DEGRO 工作组的小组成员邀请专家参加了一系列会议，补充了他们的临床经验，对文献进行了回顾，并制定了包括贝伐单抗在内的 RN 医学治疗建议，纳入临床常规。
RN 的诊断和治疗需要多学科的护理结构和明确的流程。诊断需要在多学科层面上进行，由神经放射科医生、放射肿瘤学家、神经外科医生、神经病理学家和神经肿瘤科医生共同参与。建议采用多步骤的方法，有机会尽可能多地回顾各种特征，以提高诊断信心。关于放射治疗（RT）技术的更多信息对于 RN 的诊断至关重要。对未治疗和进展性 RN 的误诊可导致严重的神经功能缺损。在本实践指南中，我们提出了一个详细的治疗相关变化命名法，并提出了一个多步骤的诊断方法。
