Radiation therapy with stereotactic radiosurgery (SRS) or whole brain radiation therapy is a mainstay of treatment for patients with brain metastases. The use of SRS in the management of brain metastases is becoming increasingly common and provides excellent local control. Cerebral radiation necrosis (RN) is a late complication of radiation treatment that can be seen months to years following treatment and is often indistinguishable from tumor progression on conventional imaging. In this review article, we explore risk factors associated with the development of radiation necrosis, advanced imaging modalities used to aid in diagnosis, and potential treatment strategies to manage side effects.

中文翻译：

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放射性坏死在脑转移瘤治疗中从诊断到治疗的困境

立体定向放射外科 (SRS) 放射治疗或全脑放射治疗是脑转移患者的主要治疗方法。SRS 在脑转移瘤治疗中的应用越来越普遍，并提供出色的局部控制。脑放射性坏死（RN）是放射治疗的晚期并发症，可以在治疗后数月至数年内观察到，并且通常与常规成像上的肿瘤进展难以区分。在这篇综述文章中，我们探讨了与放射性坏死发生相关的危险因素、用于辅助诊断的先进成像方式以及管理副作用的潜在治疗策略。