Radiation Necrosis vs Tumor growth after 3 years - 1261145

walsh305
Posts:1

I did radiation therapy in spring of 2010. I had an onset of seizures in the fall of 2010 whereby it was suggested I had radiation necrosis (as opposed to tumor recurrence). MRI in March 2013 showed stability versus prior scans. In August 2013 my tumor had appeared to have grown versus scan in March 2013. In addition, swelling was now present. I have known about this tumor for over 20 years and during that time it has been very slow growing, but current change this year has been far greater. My doctor advised there was tumor enhancement as well, not previously seen ever. Can radiation necrosis show worsening after 3 years from radiation treatment? I know from reading that it is difficult to differentiate but wasn't sure if 3 years is outside of the window of accelerating side effects. Thanks for any feedback.

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Reply # - December 20, 2013, 01:17 PM

catdander
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Hi walsh205, I'm sorry you're having issues after this period of time. I did a search on Grace for radiation necrosis and found these results. http://cancergrace.org/search-results?q=radiation%20necrosis
The first one I read talked about a difference in brain tumors from metastases and those originated in the brain. Could you let us know which you're dealing with. In the meantime I'll ask our radiation oncologist to reply.

All the best,
Janine

Reply # - December 20, 2013, 02:07 PM

dr loiselle
Posts: 37

Hi walsh205 -

Radiation necrosis (scarring) can evolve years after radiation treatment. The likelihood depends on many factors - the type of tumor treated, the size, the location, the radiation dose, and radiation technique.

Figuring out active tumor vs. scarring from prior treatment can be a complex problem, the likelihood of each dependent on all of the factors above.

At times, MR perfusion imaging or PET scans of the brain can help - however, both of these studies have limitations and often cannot readily identify necrosis vs. active tumor.

I hope that you have a good team of physicians providing you guidance on this...

Regards,
Dr Loiselle

Reply # - July 4, 2015, 02:23 PM

btlaw123
Posts: 45

Dear Dr. Loiselle, I know this is somewhat an older post, but I have a pertinent question regarding the treatment of radiation necrosis. Is hyperbaric oxygen treatment a prefer method of choice over a chemo route say use of Avastin when steroid has not been able to control the edema from the necrosis?

Which one of the above mentioned treatment approach has the least potential bad side effect? Thank you in advance for your input and insight.

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