DEGRO practical guideline for central nervous system radiation necrosis part 1: classification and a multistep approach for diagnosis

Bernhardt D, Koenig L, Grosu AL, Wiestler B, Rieken S, Wick W, Gempt J, Krieg SM, Schmidt-Graf F, Sahm F, Meyer B, Krause BJ, Petersen C, Fietkau R, Thomas M, Giordano F, Wittig-Sauerwein A, Debus J, Tabatabai G, Hau P, Steinbach J, Combs SE (2022)

Publication Type: Journal article, Review article

Publication year: 2022

Journal

Strahlentherapie und Onkologie Urban & Vogel

DOI: 10.1007/s00066-022-01994-3

Abstract

Purpose: 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). Methods: 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. Conclusion: 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.

Authors with CRIS profile

Rainer Fietkau Lehrstuhl für Strahlentherapie

Additional Organisation(s)

Tumorzentrum der Universität Erlangen-Nürnberg

Involved external institutions

Eberhard Karls Universität Tübingen DE Germany (DE) Universitätsklinikum Bonn DE Germany (DE) Technische Universität München (TUM) DE Germany (DE) Universitätsklinikum Heidelberg DE Germany (DE) Universitätsklinikum Göttingen DE Germany (DE) Deutsches Konsortium für Translationale Krebsforschung (DKTK) DE Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) DE Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) DE Germany (DE) Universitätsmedizin Rostock DE Germany (DE) Universitätsklinikum Jena DE Germany (DE) Deutsches Krebsforschungszentrum (DKFZ) DE Germany (DE) Universitätsklinikum Regensburg DE Germany (DE)

How to cite

APA:

Bernhardt, D., Koenig, L., Grosu, A.-L., Wiestler, B., Rieken, S., Wick, W.,... Combs, S.E. (2022). DEGRO practical guideline for central nervous system radiation necrosis part 1: classification and a multistep approach for diagnosis. Strahlentherapie und Onkologie. https://doi.org/10.1007/s00066-022-01994-3

MLA:

Bernhardt, Denise, et al. "DEGRO practical guideline for central nervous system radiation necrosis part 1: classification and a multistep approach for diagnosis." Strahlentherapie und Onkologie (2022).

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