Academic Journal
Single-shot bevacizumab for cerebral radiation injury
| Title: | Single-shot bevacizumab for cerebral radiation injury |
|---|---|
| Authors: | Martin Voss, Katharina J. Wenger, Emmanouil Fokas, Marie-Thérèse Forster, Joachim P. Steinbach, Michael W. Ronellenfitsch |
| Source: | BMC Neurol BMC Neurology, Vol 21, Iss 1, Pp 1-7 (2021) |
| Publisher Information: | Springer Science and Business Media LLC, 2021. |
| Publication Year: | 2021 |
| Subject Terms: | Adult, Male, Angiogenesis Inhibitors, Brain Edema, Breast Neoplasms, Side effect, Brain Edema/etiology [MeSH], Aged [MeSH], Antibodies, Monoclonal/therapeutic use [MeSH], Brain Edema/drug therapy [MeSH], Neuro-oncology, Bevacizumab/therapeutic use [MeSH], Necrosis [MeSH], Bevacizumab/administration, Brain Injuries/drug therapy [MeSH], Magnetic Resonance Imaging [MeSH], Male [MeSH], Dexamethasone, Brain Injuries/etiology [MeSH], Radiation Injuries/drug therapy [MeSH], Radiation necrosis, Research Article, Breast Neoplasms/pathology [MeSH], Dose-Response Relationship, Drug [MeSH], Dexamethasone/therapeutic use [MeSH], Brain Edema/diagnostic imaging [MeSH], Female [MeSH], Brain Injuries/diagnostic imaging [MeSH], Brain Neoplasms/radiotherapy [MeSH], Brain/pathology [MeSH], Brain Neoplasms/secondary [MeSH], Adult [MeSH], Angiogenesis Inhibitors/administration, Humans [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Bevacizumab, Glucocorticoids/therapeutic use [MeSH], Glioma/radiotherapy [MeSH], Edema, Young Adult [MeSH], Angiogenesis Inhibitors/therapeutic use [MeSH], Necrosis, 03 medical and health sciences, 0302 clinical medicine, Humans, RC346-429, Glucocorticoids, Aged, 2. Zero hunger, ddc:610, Dose-Response Relationship, Drug, Brain Neoplasms, Antibodies, Monoclonal, Brain, Glioma, Middle Aged, Magnetic Resonance Imaging, 3. Good health, Brain Injuries, Female, Neurology. Diseases of the nervous system |
| Description: | 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. |
| Document Type: | Article Conference object Other literature type |
| File Description: | application/pdf |
| Language: | English |
| ISSN: | 1471-2377 |
| DOI: | 10.1186/s12883-021-02103-0 |
| Access URL: | https://bmcneurol.biomedcentral.com/track/pdf/10.1186/s12883-021-02103-0 https://pubmed.ncbi.nlm.nih.gov/33596839 https://doaj.org/article/0900c68c7df34b80a7e3286ce41c38ee https://link.springer.com/article/10.1186/s12883-021-02103-0 https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-021-02103-0 https://www.ncbi.nlm.nih.gov/pubmed/33596839 https://europepmc.org/article/MED/33596839 https://www.scilit.net/article/dc4a4666218b0fc651cf278482cdccaf?action=show-references https://pubmed.ncbi.nlm.nih.gov/33596839/ https://repository.publisso.de/resource/frl:6462715 |
| Rights: | CC BY |
| Accession Number: | edsair.doi.dedup.....ce2ac295f8af1965dec9876002bb6c78 |
| Database: | OpenAIRE |
| ISSN: | 14712377 |
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| DOI: | 10.1186/s12883-021-02103-0 |