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- Title
Single-shot bevacizumab for cerebral radiation injury.
- Authors
Voss, Martin; Wenger, Katharina J.; Fokas, Emmanouil; Forster, Marie-Thérèse; Steinbach, Joachim P.; Ronellenfitsch, Michael W.
- Abstract
Background: Cerebral radiation injury, including subacute radiation reactions and later stage radiation necrosis, is a severe side effect of brain tumor radiotherapy. A protocol of four infusions of the monoclonal antibody bevacizumab has been shown to be a highly effective treatment. However, bevacizumab is costly and can cause severe complications including thrombosis, bleeding and gastrointestinal perforations. Methods: We performed a retrospective analysis of patients treated in our clinic for cerebral radiation injury who received only a singular treatment with bevacizumab. Single-shot was defined as a singular administration of bevacizumab without a second administration during an interval of at least 6 weeks. Results: We identified 11 patients who had received a singular administration of bevacizumab to treat cerebral radiation injury. Prior radiation had been administered to treat gliomas (ten patients) or breast cancer brain metastases (one patient). 9 of 10 patients with available MRIs showed a marked reduction of edema at first follow-up. Discontinuation of Dexamethasone was possible in 6 patients and a significant dose reduction could be achieved in all other patients. One patient developed pulmonary artery embolism 2 months after bevacizumab administration. The median time to treatment failure of any cause was 3 months. Conclusions: Single-shot bevacizumab therefore has meaningful activity in cerebral radiation injury, but durable control is rarely achieved. In patients where a complete protocol of four infusions with bevacizumab is not feasible due to medical contraindications or lack of reimbursement, single-shot bevacizumab treatment may be considered.
- Subjects
BRAIN tumors; RADIATION injuries; BEVACIZUMAB; METASTATIC breast cancer; MONOCLONAL antibodies; BACKGROUND radiation
- Publication
BMC Neurology, 2021, Vol 21, Issue 1, p1
- ISSN
1471-2377
- Publication type
Article
- DOI
10.1186/s12883-021-02103-0