TY - JOUR
T1 - Brain Metastasis Recurrence Versus Radiation Necrosis
T2 - Evaluation and Treatment
AU - Lee, Dennis
AU - Riestenberg, Robert A.
AU - Haskell-Mendoza, Aden
AU - Bloch, Orin
PY - 2020
Y1 - 2020
N2 - Radiation necrosis (RN) occurs in 5% to 25% of patients with brain metastases treated with stereotactic radiosurgery. RN must be distinguished from recurrent tumor to determine appropriate treatment. Stereotactic biopsy remains the gold standard for identifying RN. Initial treatment of RN often involves management of edema using corticosteroids, antiangiogenic therapies, and hyperbaric oxygen therapy. For refractory symptoms, surgical resection can be considered. Minimally invasive stereotactic laser ablation has the benefit of providing tissue diagnosis and treating RN or recurrent tumor with similar efficacy. Laser ablation should be considered for lesions in need of intervention where the diagnosis requires tissue confirmation.
AB - Radiation necrosis (RN) occurs in 5% to 25% of patients with brain metastases treated with stereotactic radiosurgery. RN must be distinguished from recurrent tumor to determine appropriate treatment. Stereotactic biopsy remains the gold standard for identifying RN. Initial treatment of RN often involves management of edema using corticosteroids, antiangiogenic therapies, and hyperbaric oxygen therapy. For refractory symptoms, surgical resection can be considered. Minimally invasive stereotactic laser ablation has the benefit of providing tissue diagnosis and treating RN or recurrent tumor with similar efficacy. Laser ablation should be considered for lesions in need of intervention where the diagnosis requires tissue confirmation.
KW - Brain metastases
KW - Radiation necrosis
KW - Radionecrosis
KW - Recurrence
KW - Stereotactic radiosurgery
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U2 - 10.1016/j.nec.2020.06.007
DO - 10.1016/j.nec.2020.06.007
M3 - Review article
C2 - 32921353
AN - SCOPUS:85089489722
JO - Neurosurgery Clinics of North America
JF - Neurosurgery Clinics of North America
SN - 1042-3680
ER -