title: Prolonged treatment with bevacizumab is associated with brain atrophy: a pilot study in patients with high-grade gliomas.
abstract: Bevacizumab is widely used for treatment of high-grade gliomas and other malignancies. Because bevacizumab has been shown to be associated with neurocognitive decline, this study is designed to investigate whether prolonged treatment with bevacizumab is also associated with brain atrophy. We identified 12 high-grade glioma patients who received bevacizumab for 12 months at the first recurrence and 13 matched controls and blindly compared the volumes of the contralateral hemispheres and contralateral ventricle in these two groups at baseline and after 12 ± 2 months of the baseline scan by two independent analyses. The volumes of the contralateral hemispheres and ventricles did not differ significantly between the two groups at baseline. Whereas, in the control group the volumes of the contralateral hemisphere changed subtly from baseline to follow-up (p = 0.23), in the bevacizumab-treated group the volumes significantly decreased from baseline to follow-up (p = 0.03). There was significant increase in the contralateral ventricle volume from base line to follow-up scans in both the control group (p = 0.01) and in the bevacizumab group (p = 0.005). Both the absolute and the percentage changes of contralateral hemisphere volumes and contralateral ventricular volumes between the two patient groups were statistically significant (p < 0.05). Results of this study demonstrate prolonged treatment with bevacizumab is associated with atrophy of the contralateral brain hemisphere.
authors.affiliation: Department of Radiology, The University of Alabama at Birmingham, Birmingham, USA.
authors.forename: Asim K
authors.initials: AK
authors.lastname: Bag
authors.forename: Hyunki
authors.initials: H
authors.lastname: Kim
authors.forename: Yi
authors.initials: Y
authors.lastname: Gao
authors.forename: Mark
authors.initials: M
authors.lastname: Bolding
authors.forename: Paula P
authors.initials: PP
authors.lastname: Warren
authors.forename: Hassan M
authors.initials: HM
authors.lastname: Fathallah-Shaykh
authors.forename: Demet
authors.initials: D
authors.lastname: Gurler
authors.forename: James M
authors.initials: JM
authors.lastname: Markert
authors.forename: John
authors.initials: J
authors.lastname: Fiveash
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Beasley
authors.forename: Ayaz
authors.initials: A
authors.lastname: Khawaja
authors.forename: Gregory K
authors.initials: GK
authors.lastname: Friedman
authors.forename: Philip R
authors.initials: PR
authors.lastname: Chapman
authors.forename: Louis B
authors.initials: LB
authors.lastname: Nabors
authors.forename: Xiaosi
authors.initials: X
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D001284:Atrophy / Q000139:chemically induced / Q000473:pathology; D000068258:Bevacizumab / Q000009:adverse effects*; D001921:Brain / Q000187:drug effects* / Q000473:pathology*; D001932:Brain Neoplasms / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D005910:Glioma / Q000188:drug therapy; D006801:Humans; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab