Single-shot bevacizumab for cerebral radiation injury
- 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.
Author: | Martin VoßORCiDGND, Katharina Johanna Wenger-AlakmehORCiDGND, Emmanouil FokasORCiDGND, Marie-Thérèse ForsterORCiDGND, Joachim Peter SteinbachORCiDGND, Michael Wilfried RonellenfitschORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-636604 |
DOI: | https://doi.org/10.1186/s12883-021-02103-0 |
ISSN: | 1471-2377 |
Parent Title (English): | BMC neurology |
Publisher: | BioMed Central ; Berlin ; Heidelberg : Springer |
Place of publication: | London |
Document Type: | Article |
Language: | English |
Date of Publication (online): | 2021/02/17 |
Date of first Publication: | 2021/02/17 |
Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
Release Date: | 2022/09/15 |
Tag: | Bevacizumab; Dexamethasone; Edema; Radiation necrosis; Side effect |
Volume: | 21.2021 |
Issue: | art. 77 |
Article Number: | 77 |
Page Number: | 7 |
First Page: | 1 |
Last Page: | 7 |
Note: | The authors received no specific funding for this work. Open Access funding enabled and organized by Projekt DEAL. |
Institutes: | Medizin |
Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
Sammlungen: | Universitätspublikationen |
Licence (German): | Creative Commons - Namensnennung 4.0 |