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Sep 27
Education

EDU 07 - Diagnosis to Decision: Distinguishing and Managing Radiation Necrosis vs. Recurrent Brain Metastases

05:00pm - 06:00pm ET

MODERATOR(S)

Martin Tom, MD - The University of Texas MD Anderson Cancer Center

session DESCRIPTION

Over 300,000 patients are diagnosed with brain metastases each year, with the majority receiving radiosurgery. As patients live longer from improved anticancer therapies, management of the long-term outcomes of brain radiosurgery has become increasingly complex. This session will address three of the most common and most challenging clinical conundrums after radiosurgery for brain metastases using a multidisciplinary approach that is co-sponsored by both the American Society of Neuroradiology (ASNR) and International Stereotactic Radiosurgery Society (ISRS). First, an expert neuroradiologist (representing ASNR) will discuss historical and novel imaging modalities that can best distinguish radiation necrosis from tumor recurrence so that practitioners can use them in clinical practice. Second, a radiation oncologist (representing ISRS) will provide an overview of decision algorithms and multi-disciplinary workflows to manage radiation necrosis, including medications and procedures, and when to choose each option. Last, a radiation oncologist (representing ASTRO) will discuss the different options to manage recurrent brain metastases, including re-irradiation and/or surgical approaches (e.g., re-SRS, resection, brachytherapy, laser interstitial thermal therapy) and how they might be optimally combined.

learning objectives

  1. Assess which imaging modalities can best distinguish radiation necrosis from recurrent brain metastases, and subsequently implement them into clinical practice to make actionable treatment decisions.
  2. Understand the optimal and data-driven management of radiation necrosis based severity of disease and treatment related side effects.
  3. Determine the best approach to managing recurrent brain metastases with radiotherapeutic and/or surgical interventions based on patient- and disease-specific characteristics.

Credits

AMA PRA Category 1 Credits: 1.00

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