Abstract
To examine the influences of bevacizumab combined with intensity-modulated radiation therapy (IMRT) on postoperative brain glioma, particularly its impact on coagulation function and cognitive function, the complete clinical data of 156 patients undergoing glioma surgery in the neurosurgery department of our hospital between March 2015 and October 2018 were retrospectively analyzed. All patients underwent glioma surgery and were then assigned to the observation group (Obs group, n = 79, received bevacizumab combined with IMRT) or the control group (Con group, n = 77, received IMRT without bevacizumab) for analysis during postoperative treatment. The patients' short-term efficacy was evaluated, and their serum markers and coagulation function were compared, as well as the cognitive function, the occurrence of adverse reactions during treatment, the Karnofsky performance status (KPS) score, and quality of life after treatment. Patients' survival was followed up within 2 years after surgery. The Obs group showed a notably higher clinical remission rate and clinical control rate (DCR) than the Con group after treatment. The Obs group showed notably lower levels of interleukin-2 (IL-2), vascular endothelial growth factor (VEGF), IL-6, and epidermal growth factor (EGF), experienced notably shorter prothrombin time (PT) and activated partial thromboplastin time (APTT), and showed higher fibrinogen (FIB) and D-dimer (D-D) levels than Con group. The Obs group showed notably better cognitive function, KPS score, and quality of life than the Con group, but no notable difference was observed between them in the incidence of adverse reactions (P > 0.0500). The survival rates in the Obs group were higher than in the Con group. For patients with glioma, postoperative bevacizumab combined with IMRT delivers substantially higher clinical efficacy by lowering serum marker levels and improving cognitive function without significantly affecting coagulation function.
Highlights
Glioma is a frequently seen primary intracranial brain tumour, and its pathological types include astrocytoma, oligodendroglioma, ependymoma, and mixed glioma, of which astrocytoma is the most frequently seen one [1]
Coagulation function test: Venous blood was acquired from the elbow of every patient prior to radiotherapy and at 3 months after the end of radiation therapy and mixed with anticoagulant containing 0.109 mol/L sodium citrate (9 : 1), followed by 10min centrifugation (3000 r/min) with shaking, and plasma was taken for measurement. e coagulation indexes, including prothrombin time (PT), prothrombin time (TT), fibrinogen (FIB), activated partial thromboplastin time (APTT), and fibrinolytic index (D-dimer, D-D), were measured through one automatic coagulation analyzer (STA-R Evolution, France)
No notable difference was observed in the contents of IL-2, IL-6, vascular endothelial growth factor (VEGF), and epidermal growth factor (EGF) between the 2 groups before postoperative radiotherapy (P > 0.0500), while 3 months after radiotherapy, the contents of them in both groups dropped notably, with greatly lower levels in the Obs group than those in the Con group
Summary
Glioma is a frequently seen primary intracranial brain tumour, and its pathological types include astrocytoma, oligodendroglioma, ependymoma, and mixed glioma, of which astrocytoma is the most frequently seen one [1]. Intensity modulated radiotherapy (IMRT) is a commonly used adjuvant method to kill residual cancer cells and prevent tumour recurrence in recent years [9]. Due to the poor sensitivity of glioma to radiotherapy, the postoperative IMRT alone has very limited preventive value for recurrence. Bevacizumab has been approved by the US Food and Drug Administration as one antivascular agent for the therapy of recurrent high-grade gliomas [13]. Studies on coagulation function and cognitive function of patients after glioma with bevacizumab combined with IMRT have not been reported. From the perspective of coagulation function and cognitive function, this study retrospectively analyzed the impacts of bevacizumab + IMRT on postoperative patients with glioma and its impacts on cognitive function and coagulation function, providing more evidence for clinical treatment of glioma
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