脑转移瘤管理中从诊断到治疗的放射性坏死困境。
The dilemma of radiation necrosis from diagnosis to treatment in the management of brain metastases.
机构信息
Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio, USA.
Department of Radiation Oncology, University of Washington, Seattle, Washington, USA.
出版信息
Neuro Oncol. 2024 Mar 4;26(12 Suppl 2):S56-S65. doi: 10.1093/neuonc/noad188.
Abstract
Radiation therapy with stereotactic radiosurgery (SRS) or whole brain radiation therapy is a mainstay of treatment for patients with brain metastases. The use of SRS in the management of brain metastases is becoming increasingly common and provides excellent local control. Cerebral radiation necrosis (RN) is a late complication of radiation treatment that can be seen months to years following treatment and is often indistinguishable from tumor progression on conventional imaging. In this review article, we explore risk factors associated with the development of radiation necrosis, advanced imaging modalities used to aid in diagnosis, and potential treatment strategies to manage side effects.
摘要
立体定向放射外科（SRS）或全脑放疗是脑转移瘤患者的主要治疗方法。SRS 在脑转移瘤的治疗中的应用越来越普遍，提供了极好的局部控制。放射性脑坏死（RN）是放射治疗的一种晚期并发症，可在治疗后数月至数年内出现，且通常在常规影像学上与肿瘤进展难以区分。在这篇综述文章中，我们探讨了与放射性坏死发展相关的危险因素、用于辅助诊断的先进影像学手段以及潜在的治疗策略，以管理副作用。
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