Initial experience with bevacizumab treatment for biopsy confirmed cerebral radiation necrosis.
BACKGROUND
Cerebral radiation necrosis is a serious complication of radiation treatment for brain tumors. Therapeutic options include corticosteroids, anticoagulation and hyperbaric oxygen with limited efficacy. Bevacizumab, an antibody against VEGF had been reported to reduce edema in patients with suspected radiation necrosis. We retrospectively reviewed 6 patients with biopsy proven cerebral radiation necrosis treated with bevacizumab between 2006 and 2008.


RESULTS
Interval MRI follow-up demonstrated radiographic response in all patients with an average reduction of 79% for the post gadolinium studies and 49% for the FLAIR images. The initial partial radiographic response was noted for up to a mean follow-up time of 5.9 months (6 weeks to 18 months).


CONCLUSIONS
Bevacizumab appears to produce radiographic response and clinical benefits in the treatment of patients with cerebral radionecrosis.
Torcuator
Roy
R
Hermelin Brain Tumor Center, Department of Neurosurgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA. nsroy@neuro.hfh.edu
Zuniga
Richard
R
Mohan
Yedathore S
YS
Rock
Jack
J
Doyle
Thomas
T
Anderson
Joseph
J
Gutierrez
Jorge
J
Ryu
Samuel
S
Jain
Rajan
R
Rosenblum
Mark
M
Mikkelsen
Tom
T
D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001706:Biopsy / Q000379:methods; D001927:Brain Diseases / Q000188:drug therapy* / Q000473:pathology*; D001932:Brain Neoplasms / Q000532:radiotherapy; D005260:Female; D005909:Glioblastoma / Q000532:radiotherapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D011832:Radiation Injuries / Q000188:drug therapy; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D015898:Tomography Scanners, X-Ray Computed
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab