Pathophysiology, Diagnosis, and Treatment of Radiation Necrosis in the Brain

被引：118

作者：

Miyatake, Shin-Ichi ^{[1
]}

Nonoguchi, Noasuke ^{[2
]}

Furuse, Motomasa ^{[2
]}

Yoritsune, Erina ^{[2
]}

Miyata, Tomo ^{[2
]}

Kawabata, Shinji ^{[2
]}

Kuroiwa, Toshihiko ^{[2
]}

机构：

[1] Osaka Med Coll, Ctr Canc, Takatsuki, Osaka 5698686, Japan

[2] Osaka Med Coll, Dept Neurosurg, Takatsuki, Osaka 5698686, Japan

来源：

NEUROLOGIA MEDICO-CHIRURGICA | 2015年 / 55卷 / 01期

关键词：

bevacizumab; positron emission tomography; pseudoprogression; radiation necrosis; CENTRAL-NERVOUS-SYSTEM; INTERCELLULAR-ADHESION MOLECULE-1; NEUTRON-CAPTURE THERAPY; TEMPORAL-LOBE NECROSIS; STEREOTACTIC RADIOSURGERY; F-18; FLUORODEOXYGLUCOSE; TUMOR RECURRENCE; MR-SPECTROSCOPY; BEVACIZUMAB TREATMENT; MALIGNANT GLIOMAS;

D O I：

10.2176/nmc.ra.2014-0188

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

New radiation modalities have made it possible to prolong the survival of individuals with malignant brain tumors, but symptomatic radiation necrosis becomes a serious problem that can negatively affect a patient's quality of life through severe and lifelong effects. Here we review the relevant literature and introduce our original concept of the pathophysiology of brain radiation necrosis following the treatment of brain, head, and neck tumors. Regarding the pathophysiology of radiation necrosis, we introduce two major hypotheses: glial cell damage or vascular damage. For the differential diagnosis of radiation necrosis and tumor recurrence, we focus on the role of positron emission tomography. Finally, in accord with our hypothesis regarding the pathophysiology, we describe the promising effects of the anti-vascular endothelial growth factor antibody bevacizumab on symptomatic radiation necrosis in the brain.

引用

页码：50 / 59

页数：10

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