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First published on April 9, 2008
This version was published on January 1, 2008
Neuro Oncol 2008 10(3):361-367; DOI:10.1215/15228517-2008-008
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Duke University Press

Review

Disease progression or pseudoprogression after concomitant radiochemotherapy treatment: Pitfalls in neurooncology

Alba A. Brandes, Alicia Tosoni, Federica Spagnolli, Giampiero Frezza, Marco Leonardi, Fabio Calbucci and Enrico Franceschi

Departments of Medical Oncology (A.A.B., A.T., E.F.), Radiotherapy (F.S., G.F.), Neuroradiology (M.L.), and Neurosurgery (F.C.), Bellaria-Maggiore Hospital, AUSL Bologna, Bologna, Italy

Address correspondence to Alba A. Brandes, Department of Medical Oncology, Azienda USL Bellaria-Maggiore, Bologna, Italy (alba.brandes{at}yahoo.it).

Although radionecrosis has been exhaustively described in depth in the neurooncological literature, its diagnosis is still a challenging issue because its radiological pattern is frequently indistinguishable from that of tumor recurrence. This review discusses the causes of radionecrosis and the potential effect of adjuvant chemotherapy concomitant with radiotherapy on its rate and onset. The potential pitfalls in clinical studies attempting to make a differential diagnosis between radionecrosis and disease progression are also discussed.

Key Words: chemotherapy • glioma • pseudoprogression • radionecrosis • radiotherapy


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Copyright 2008 by Society for Neuro-Oncology