Radiation necrosis in a population of high grade glioma patients: The Alfred experience

Seventeen cases (12 GBM, 5AA) of radiation necrosis (RTN) were identified from 439 patients with high grade glioma treated at the Alfred Hospital between July 1993 and Nov 2002. Identification was based on biopsy apart from 3 patients with resolving imaging changes without intervention. Pathological review demonstrated 9 cases of pure or predominantly RTN and 5 cases of necrosis mixed with viable tumour. Six patients required surgery for symptom relief and the remainder to confirm or establish the diagnosis. Age, dose, pathology, performance status, presence of diabetes and hypertension were examined as possible risk factors for the study population. It was noted that 36 patients had received a stereotactic boost with seven of these developing radiation necrosis