TY  - JOUR
A1  - Voß, Martin
A1  - Wenger-Alakmeh, Katharina Johanna
A1  - Fokas, Emmanouil
A1  - Forster, Marie-Thérèse
A1  - Steinbach, Joachim Peter
A1  - Ronellenfitsch, Michael Wilfried
T1  - Single-shot bevacizumab for cerebral radiation injury
T2  - BMC neurology
N2  - 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.
KW  - Radiation necrosis
KW  - Bevacizumab
KW  - Dexamethasone
KW  - Side effect
KW  - Edema
Y1  - 2021
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/63660
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-636604
SN  - 1471-2377
N1  - The authors received no specific funding for this work. Open Access funding enabled and organized by Projekt DEAL.
VL  - 21.2021
IS  - art. 77
SP  - 1
EP  - 7
PB  - BioMed Central ; Berlin ; Heidelberg : Springer
CY  - London
ER  -