Viable treatment options for patients with symptomatic radiation necrosis treated with stereotactic radiosurgery and immunotherapy

Immune checkpoint inhibitors (ICIs) have demonstrated clinical benefit in phase III trials and have become first- or second-line therapy for many cancers that metastasize to the brain (e.g., lung, melanoma, and renal cell carcinoma) [2,3]. [15] demonstrated a surgical morbidity rate of 54% in 11 pat...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2019-09, Vol.184, p.105444-105444, Article 105444
Main Authors: Shah, Aatman, Downey, Brianna, Menacho, Sarah T.
Format: Article
Language:English
Subjects:
Brain
Brain cancer
Brain Neoplasms - surgery
Clear cell-type renal cell carcinoma
Clinical trials
Edema
Humans
Immune checkpoint inhibitors
Immunotherapy
Kidney cancer
Lasers
Lungs
Medical personnel
Melanoma
Metastases
Metastasis
Morbidity
Necrosis
Neurology
Patients
Radiation
Radiation Injuries
Radiology
Radiosurgery
Refractory materials
Renal cell carcinoma
Surgery
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Summary:Immune checkpoint inhibitors (ICIs) have demonstrated clinical benefit in phase III trials and have become first- or second-line therapy for many cancers that metastasize to the brain (e.g., lung, melanoma, and renal cell carcinoma) [2,3]. [15] demonstrated a surgical morbidity rate of 54% in 11 patients who underwent resection of RN. Because of the morbidity and unclear survival benefits, the authors stated that surgery should be reserved for cases that are refractory to medical management. Given that a growing number of patients with metastatic brain cancer treated with SRS will also receive an ICI, it is important for treating physicians to be aware of all of the treatment modalities available for RN.
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2019.105444