Journal Article (Review Article)

DKFZ-2022-02056

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png DEGRO practical guideline for central nervous system radiation necrosis part 2: treatment.

Bernhardt, D.DKFZ* ; König, L.DKFZ* ; Grosu, A.-L.DKFZ* ; Rieken, S. ; Krieg, S. M. ; Wick, W.DKFZ* ; Wiestler, B. ; Schmidt-Graf, F. ; Sahm, F.DKFZ* ; Gempt, J. ; Meyer, B. ; Krause, B. J. ; Petersen, C. ; Fietkau, R. ; Thomas, M. ; Giordano, F. ; Wittig-Sauerwein, A. ; Debus, J.DKFZ* ; Tabatabai, G. ; Hau, P. ; Steinbach, J. ; Combs, S. E.DKFZ* ; Oncology, E. P. o. t. G. S. o. R. (Collaboration Author)

2022
Springer Medizin Heidelberg

Abstract: The 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).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 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.

Keyword(s): Bevacizumab ; Blood–brain barrier disruptions ; Brain metastases ; Glioma ; Radiation necrosis ; Stereotactic radiotherapy ; Steroids

Note: 2022 Nov;198(11):971-980

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Contributing Institute(s):

1. DKTK Koordinierungsstelle München (MU01)
2. E050 KKE Strahlentherapie (E050)
3. KKE Neuroonkologie (B320)
4. KKE Neuropathologie (B300)
5. DKTK HD zentral (HD01)
6. DKTK Koordinierungsstelle Freiburg (FR01)

Research Program(s):

1. 315 - Bildgebung und Radioonkologie (POF4-315) (POF4-315)

Appears in the scientific report 2022

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Springer ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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