Radiation Necrosis

What is Radiation Necrosis?

Radiation necrosis is a serious complication that can occur after radiation therapy. It can happen when healthy tissue is damaged by radiation and begins to break down or die. In the brain, radiation necrosis may develop months or even years after radiation therapy treatment.

While radiation therapy is designed to target cancer cells, nearby healthy tissue can sometimes be affected. Radiation necrosis is not a cancer recurrence, but it can cause symptoms that are similar to growing a tumor.

Who is Affected?

Radiation necrosis most commonly affects individuals who have received radiation therapy or radiosurgery to treat brain tumors, metastatic cancer to the brain, or head and neck cancers.

Not every person who receives radiation therapy develops necrosis. It is considered a rare but potentially serious side effect.

What Causes Radiation Necrosis?

Radiation necrosis occurs when radiation damages blood vessels and healthy tissue in the treated area. Over time, this damage can reduce blood supply and lead to tissue breakdown.

Risk Factors

Not Controllable

• History of radiation therapy to the brain, head and/or neck
• History of stereotactic radiosurgery to the brain, head and/or neck
• Large treatment areas with radiation
• Higher total doses of radiation

Controllable

• None

How is Radiation Necrosis Diagnosed?

Radiation necrosis can be difficult to distinguish from a tumor recurrence because both may appear similar in imaging studies.

Diagnosis often involves a combination of imaging tests and clinical evaluation.

What Tests are Used?

Different tests may be used depending on the symptoms. These tests may include:

• MRI
• CT Scan
• Other advanced imaging techniques to assess blood flow
• Biopsies in some situations

How is Radiation Necrosis Treated?

Treatment depends on the severity of symptoms and the extent of the tissue damage.

Treatment depends on the severity of symptoms and the extent of tissue damage.

Lifestyle

• Close monitoring and follow-up imaging
• Symptom management

Medical

• Corticosteroids to reduce swelling
• Medications to control seizures or other symptoms

Surgical

• Surgical removal of damaged tissue in some cases
• Minimally invasive procedures such as Laser Interstitial Thermal Therapy (LITT) may be an option

When to Seek Care

When to See Your Doctor

Contact your doctor if you experience new or worsening neurological symptoms after radiation therapy, including headaches, weakness, seizures or changes in memory or speech.

When to Seek Emergency Medical Care
Call 911 or seek emergency medical care if you experience:

• Sudden weakness or paralysis
• Severe or sudden headache
• New seizure activity
• Sudden confusion
• Loss of consciousness

What Should You Do Next?

If you have previously received radiation therapy or radiosurgery treatment and are experiencing new neurological symptoms, talk to your doctor. Early assessment can help determine whether the symptoms are due to radiation necrosis, tumor recurrence or another condition.