Abstract
Objective: The aim of the paper was to investigate the recurrence and its causes of radiation brain necrosis following bevacizumab discontinuation. Methods: This study included 14 patients with radiation brain necrosis (confirmed through imaging) after stereotactic radiotherapy for a primary or metastatic brain tumor and who received bevacizumab treatment from June 2011 through December 2014. The patients received bevacizumab at 5 mg/kg, q3-4w, for at least 3 cycles. The T1 signal intensity from enhanced MRI images was used as the evaluation criteria for the brain necrosis treatment efficacy. Results: brain necrosis improved in 13 of the 14 cases (92.9%). However, during follow-up, 10 of the 13 responsive patients (76.9%) exhibited a recurrence in brain necrosis, and a multiple linear regression analysis shows that brain necrosis recurrence was related to the follow-up time after the initial bevacizumab treatment discontinuation. Conclusion: bevacizumab produced good short-term effects for radiation brain necrosis; however, most of the patients would recurrence after bevacizumab is discontinued. Thus, brain necrosis was irreversible.
Highlights
MATERIALS AND METHODSRadiation brain necrosis is a common complication after brain tumor radiotherapy [1,2,3]
Data for patients with radiation brain necrosis progression after bevacizumab discontinuation For the 13 patients who responded to bevacizumab treatment, the median follow-up time after bevacizumab was discontinued following the first-course treatment was10.0 months (1.2-38.0 months),and 10patients (76.9%) recurrence
We performed a comparative analysis of the patients who responded to the first course of bevacizumab treatment and considered factors such as the biologically effective dose (BED) of stereotactic radiotherapy, number of cycles during the first course of bevacizumab treatment, brain necrosis volume before bevacizumab treatment, brain necrosis residual volume after the first course of bevacizumab treatment, and follow-up time after bevacizumab was discontinued following the first course of treatment
Summary
MATERIALS AND METHODSRadiation brain necrosis is a common complication after brain tumor radiotherapy [1,2,3]. To provide a reference for clinical treatment, we statistically analyzed bevacizumab treatment efficacy in patients with radiation brain necrosis treated at the Tianjin Cancer Hospital and their progression after bevacizumab discontinuation.
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