Treatment of Radiation-Induced Brain Necrosis.

Xiaojing Yang,Jie Fu,Jayeeta Ghose,Hanru Ren

doi:10.1155/2021/4793517

Abstract

Radiation-induced brain necrosis (RBN) is a serious complication of intracranial as well as skull base tumors after radiotherapy. In the past, due to the lack of effective treatment, radiation brain necrosis was considered to be progressive and irreversible. With better understanding in histopathology and neuroimaging, the occurrence and development of RBN have been gradually clarified, and new treatment methods are constantly emerging. In recent years, some scholars have tried to treat RBN with bevacizumab, nerve growth factor, and gangliosides and have achieved similar results. Some cases of brain necrosis can be repairable and reversible. We aimed to summarize the incidence, pathogenesis, and treatment of RBN.

Highlights

Radiation therapy is regarded as an important therapy to treat brain tumors, and its efficacy has been confirmed [1]
1α, IL-6, and transforming growth factor (TGF)-β [50, 51]. This chronic inflammation, which is different from cytokines, might play a role in the development of radiation-induced brain necrosis (RBN) due to excessive production of proinflammatory cytokines, which is the pathophysiological mechanism of many neurodegenerative diseases [52], but how the abnormal expression of cytokines and the inflammatory response eventually led to brain necrosis needs further study
Patients diagnosed with radiation necrosis must have a history of head and neck radiotherapy; RBN can appear after radiotherapy for benign and malignant tumors, and it is more common in malignant tumors, which may be related to the high radiation dose; RBN usually occurs half a year to a year after radiotherapy

Summary

Introduction

Radiation therapy is regarded as an important therapy to treat brain tumors, and its efficacy has been confirmed [1]. The occurrence and development of radiation-induced brain necrosis (RBN) depend on the total radiation dose, the fraction size, and the volume of the brain. The higher the total radiation dose is, the larger the split dose is, the larger the brain volume is, and the higher the incidence of RBN [4]. The higher the total radiation dose, the easier will be the early occurrence of RBN. This tumor type manifests as headache, insanity, dizziness, memory loss, personality changes, and seizures [5]. These symptoms severely affect the quality of life of patients. We aimed to summarize the incidence of RBN, its pathogenesis, diagnosis, and treatment plans and strategies, as well as the prognostic indicators and how to prevent these

Epidemiology

Pathophysiology

Mechanism

Diagnosis

Treatment

Future Opportunities

Prognostic Factor

Prevention

10. Conclusions

Findings

Conflicts of Interest