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REVIEW ARTICLE
Year : 2017  |  Volume : 8  |  Issue : 3  |  Page : 135-140

Adverse radiation effect in the brain during cancer radiotherapy


1 Department of Neurosurgery, Roswell Park Cancer Institute; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA
2 Department of Radiation Oncology, Roswell Park Cancer Institute, University at Buffalo, State University of New York, Buffalo, New York, USA
3 Department of Pathology, Roswell Park Cancer Institute, University at Buffalo, State University of New York, Buffalo, New York, USA

Correspondence Address:
Andrew J Fabiano
Department of Neurosurgery, Roswell Park Cancer Institute; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrcr.jrcr_33_17

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Adverse radiation effect (ARE) in the brain is the reactive inflammation, vasculitis, and necrosis that occurs as a complication of radiotherapy. There are two main categories of ARE that result in vasogenic cerebral edema: first, a residual irritant mass of the targeted lesion; and second, radiation-damaged perilesional normal brain tissue in a reactive state. Radiation injury leads to fibrinoid and coagulative necrosis of different cell types and fibrinoid necrosis and hyalinization of vessels. The clinical consequence of ARE is neurologic impairment secondary to vasogenic edema in the normal brain. Neuroimaging may aid in differentiating tumor recurrence from ARE. However, imaging studies are not definitive, and their utility in this setting remains controversial. The management of patients with ARE is dictated by symptom occurrence. The definitive management of symptomatic ARE is craniotomy and resection. Alternative therapies include bevacizumab, laser-interstitial thermal therapy, and reirradiation.


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