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First published on April 9, 2008
A more recent version of this article appeared on January 1, 2008
Neuro Oncol 2008, DOI:10.1215/15228517-2008-008
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© Copyright 2008 by the Society for Neuro-Oncology

Received March 5, 2007
Accepted June 10, 2007

Review

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

Alba A. Brandes 1*, Alicia Tosoni 1, Federica Spagnolli 2, Giampiero Frezza 2, Marco Leonardi 3, Fabio Calbucci 4, Enrico Franceschi 1

1 Department of Medical Oncology, Bellaria-Maggiore Hospital, AUSL Bologna, Bologna, Italy
2 Department of Radiotherapy, Bellaria-Maggiore Hospital, AUSL Bologna, Bologna, Italy
3 Department of Neuroradiology, Bellaria-Maggiore Hospital, AUSL Bologna, Bologna, Italy
4 Department of Neurosurgery, Bellaria-Maggiore Hospital, AUSL Bologna, Bologna, Italy

* To whom correspondence should be addressed. E-mail: alba.brandes{at}yahoo.it.


  Abstract

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