The onset of radionecrosis may be delayed, sometimes appearing months or even years after radiation therapy, as the full extent of tissue damage becomes apparent. Symptoms vary depending on the affected area but often include persistent pain, swelling, ulceration, infection, and functional impairment. In cases involving the spinal cord, neurological deficits such as paralysis or sensory loss may occur. Severe radionecrosis can lead to systemic complications, including sepsis or organ failure, particularly if infection develops in necrotic tissue.
Risk factors for radionecrosis include high radiation doses, large treatment volumes, and pre-existing conditions that compromise tissue healing, such as diabetes or vascular disease. Certain anatomical sites, like the pelvis or head and neck region, are particularly susceptible due to their complex structures and limited tolerance to radiation. Diagnosis typically involves clinical evaluation, imaging studies (such as MRI or CT scans), and sometimes biopsy to rule out other conditions like infection or tumor recurrence.
Treatment focuses on managing symptoms and preventing complications. Pain control, wound care, and antibiotic therapy are often employed to address infection. In advanced cases, surgical debridement or hyperbaric oxygen therapy may be considered to promote healing. However, complete recovery is not always possible, and long-term disability may result. Prevention strategies emphasize careful dose planning in radiotherapy, minimizing exposure to healthy tissues, and monitoring patients for early signs of complications.
Prognosis depends on the extent of tissue damage and the affected area, with some patients experiencing significant functional recovery while others face permanent disability. Ongoing research aims to improve radiation techniques and supportive therapies to reduce the incidence and severity of radionecrosis.