DEGRO practical guideline for central nervous system radiation necrosis part 2: treatment.

Humans Radiosurgery Bevacizumab / therapeutic use Radiation Injuries / etiology Central Nervous System Necrosis
Bevacizumab Blood–brain barrier disruptions Brain metastases Glioma Radiation necrosis Stereotactic radiotherapy Steroids

Journal

Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
ISSN: 1439-099X
Titre abrégé: Strahlenther Onkol
Pays: Germany
ID NLM: 8603469

Informations de publication

Date de publication:
11 2022
Historique:
received: 11 06 2022
accepted: 15 06 2022
pubmed: 30 8 2022
medline: 22 10 2022
entrez: 29 8 2022
Statut: ppublish

Résumé

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.

Identifiants

DOI: 10.1007/s00066-022-01973-8 PMID: 36038670 PMC: PMC9581806
pubmed: 36038670
doi: 10.1007/s00066-022-01973-8
pii: 10.1007/s00066-022-01973-8
pmc: PMC9581806
doi:

Substances chimiques

Bevacizumab 2S9ZZM9Q9V

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

971-980

Informations de copyright

© 2022. The Author(s).

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Auteurs

Denise Bernhardt (D)

Klinik und Poliklinik für Radioonkologie und Strahlentherapie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany. Denise.bernhardt@mri.tum.de.
Partner Sites Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Freiburg and Heidelberg, Germany. Denise.bernhardt@mri.tum.de.
ORCID: 0000-0001-5231-9097

Laila König (L)

Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberger Ionenstrahltherapie-Zentrum (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
National Center for Tumor diseases (NCT), 69120, Heidelberg, Germany.

Anca-L Grosu (AL)

Partner Sites Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Freiburg and Heidelberg, Germany.
Department of Radiation Oncology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Robert-Koch-Str. 3, 79106, Freiburg, Germany.

Stefan Rieken (S)

Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.

Sandro M Krieg (SM)

Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.

Wolfgang Wick (W)

Clinical Cooperation Unit Neurooncology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
Department of Neurology and Neurooncology Program, National Center for Tumor Diseases, Heidelberg University Hospital, 69120, Heidelberg, Germany.

Benedikt Wiestler (B)

Department of Neuroradiology, Technical University Munich, School of Medicine, Klinikum rechts der Isar, 81675, Munich, Germany.

Friederike Schmidt-Graf (F)

Department of Neurology, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.

Felix Sahm (F)

Department of Neuropathology, University Hospital Heidelberg and CCU Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.

Jens Gempt (J)

Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.

Bernhard Meyer (B)

Department of Neurosurgery, Technical University Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.

Bernd J Krause (BJ)

Department of Nuclear Medicine, Rostock University Medical Centre, 18057, Rostock, Germany.

Cordula Petersen (C)

Department of Radiotherapy and Radiation Oncology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.

Rainer Fietkau (R)

Department of Radiation Oncology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, 2306, Erlangen, Germany.
Comprehensive Cancer Center Erlangen-European Metropolitan Region of Nuremberg (CCC ER-EMN), 91054, Erlangen, Germany.

Michael Thomas (M)

Department of Thoracic Oncology, Thoraxklinik at Heidelberg University Hospital, 69120, Heidelberg, Germany.
Member of the German Center for Lung Research (DZL), Translational Lung Research Center Heidelberg (TLRC-H), 69120, Heidelberg, Germany.
National Center for Tumor Diseases (NCT), Heidelberg, Germany, 69120.

Frank Giordano (F)

Department of Radiation Oncology, University Hospital Bonn, 53127, Bonn, Germany.

Andrea Wittig-Sauerwein (A)

Department of Radiotherapy and Radiation Oncology, University Hospital Jena, Bachstraße 18, 07743, Jena, Germany.

Jürgen Debus (J)

Partner Sites Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Freiburg and Heidelberg, Germany.
Klinik für Radioonkologie und Strahlentherapie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Heidelberger Ionenstrahltherapie-Zentrum (HIT), Im Neuenheimer Feld 450, 69120, Heidelberg, Germany.
Heidelberg Institute of Radiation Oncology (HIRO), Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.
National Center for Tumor diseases (NCT), 69120, Heidelberg, Germany.

Ghazaleh Tabatabai (G)

Department of Neurosurgery, University Hospital Tuebingen, Eberhard Karls University Tuebingen, 72076, Tuebingen, Germany.
Center for Neuro-Oncology, Comprehensive Cancer Center Tuebingen Stuttgart, University Hospital Tuebingen, Eberhard Karls University of Tuebingen, 72076, Tuebingen, Germany.
Department of Neurology, Eberhard Karls University of Tuebingen, 72076, Tuebingen, Germany.
Department Interdisciplinary Neuro-Oncology, Eberhard Karls University of Tuebingen, 72076, Tuebingen, Germany.

Peter Hau (P)

Wilhelm Sander-NeuroOncology Unit and Department of Neurology, University Hospital Regensburg, 93053, Regensburg, Germany.

Joachim Steinbach (J)

Dr Senckenberg Institute of Neurooncology, University Hospital, 60325, Frankfurt am Main, Germany.

Stephanie E Combs (SE)

Klinik und Poliklinik für Radioonkologie und Strahlentherapie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, Munich, Germany.
Institute of Radiation Medicine (IRM), Department of Radiation Sciences (DRS), Helmholtz Zentrum München (HMGU), Ingolstädter Landstraße Ingolstädter Landstraße 1, 85764, Oberschleißheim, Germany.
Partner Sites Munich, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Freiburg and Heidelberg, Germany.

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questionsmedicales.fr › Techniques d'investigation › Techniques stéréotaxiques › Radiochirurgie › DEGRO practical guideline for central nervous...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Globulines › Sérum-globulines › Immunoglobulines › Anticorps › Anticorps monoclonaux › Anticorps monoclonaux humanisés › Bévacizumab › DEGRO practical guideline for central nervous...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Hygiène radiologique › Effets des rayonnements › Lésions radiques › DEGRO practical guideline for central nervous...
questionsmedicales.fr › Système nerveux › Système nerveux central › DEGRO practical guideline for central nervous...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Nécrose › DEGRO practical guideline for central nervous...