Low-Dosage Bevacizumab Treatment: Effect on Radiation Necrosis After Gamma Knife Radiosurgery for Brain Metastases

Weng, Yang; Shen, Jie; Zhang, Luyuan; Fang, Zebin; Xiao, Feng; Zhang, Chao; Fan, Zuoxu; Huang, Kejie; Wang, Liyun; Huang, Bin; Wu, Fan; Zhang, Tiesong; Xu, Qin

doi:10.3389/fsurg.2021.720506

Cited by 5 publications

(44 citation statements)

References 31 publications

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“…Two non-randomized studies were published in 2022, 13,14 2 non-randomized studies were published in 2021, 15,16 1 non-randomized study was published in 2017, 17 and 1 non-randomized study was published in 2016. 18 Four of the non-randomized studies were single-arm retrospective cohort studies that used historical patient data to compare the change in outcomes before and after treatment.…”

Section: Methodsmentioning

confidence: 99%

“…18 Four of the non-randomized studies were single-arm retrospective cohort studies that used historical patient data to compare the change in outcomes before and after treatment. 13,[15][16][17] Two of the non-randomized studies were single-arm prospective cohort studies that collected patient data prospectively to compare the change in outcomes before and after treatment. 14,18 When reported, patient follow-up times varied across each study, but ranged from 6 months to 14.2 months.…”

Section: Methodsmentioning

confidence: 99%

“…Four SRs 9-12 including 1 with meta-analysis 9 and 6 non-randomized studies [13][14][15][16][17][18] were included in this report.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

“…The included SRs were conducted in China, 9,10 Italy, 11 and the US. 12 The included non-randomized studies were conducted in Canada, 13 the US, 14 China, [15][16][17] and Japan. 18…”

Section: Country Of Originmentioning

confidence: 99%

“…[9][10][11][12] Each non-randomized study included patients who had undergone radiosurgery, were diagnosed with brain radionecrosis, and were subsequently treated with bevacizumab. [13][14][15][16][17][18] The number of patients included in each non-randomized study ranged from 10 to 40, and the mean or median age of patients ranged from 35.1 years to 64 years. [13][14][15][16][17][18]…”

Section: Patient Populationmentioning

confidence: 99%

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Bevacizumab for the Treatment of Patients With Brain Radionecrosis

Hill¹,

MacDougall²

2022

cjht

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This review identified limited evidence regarding the clinical effectiveness and safety of bevacizumab for patients with symptomatic brain radionecrosis after radiosurgery. These identified studies had several limitations, most notably due to the limited number of studies with control groups; therefore, the findings related to the effectiveness and safety in this population are uncertain. For adult patients with symptomatic brain radionecrosis, treatment with bevacizumab may be associated with radiographic responses, a reduction in volumetric outcomes, an improvement in overall clinical and neurologic symptoms, an improvement in functional outcomes, and a reduction in corticosteroid use. Limited evidence from 1 study suggests that treatment with bevacizumab may be associated with greater radiographic response, a reduction in volumetric outcomes, and clinical symptom improvement compared to treatment with corticosteroids. The recurrence of brain radionecrosis for patients who received bevacizumab compared to corticosteroids was similar between groups. Commonly reported adverse events after patients with symptomatic brain radionecrosis were treated with bevacizumab included hypertension, proteinuria, edema, pulmonary embolism, and various thromboembolic events.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Four SRs 9-12 including 1 with meta-analysis 9 and 6 non-randomized studies [13][14][15][16][17][18] were included in this report.…”

Section: Summary Of Study Characteristicsmentioning

confidence: 99%

“…The included SRs were conducted in China, 9,10 Italy, 11 and the US. 12 The included non-randomized studies were conducted in Canada, 13 the US, 14 China, [15][16][17] and Japan. 18…”

Section: Country Of Originmentioning

confidence: 99%

Section: Patient Populationmentioning

confidence: 99%

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Bevacizumab for the Treatment of Patients With Brain Radionecrosis

Hill¹,

MacDougall²

2022

cjht

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Cognitive dysfunction induced by cranial radiotherapy: mechanisms and therapeutic methods

Li,

Ding

2024

Brain Research Bulletin

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Can low‐dose intravenous bevacizumab be as effective as high‐dose bevacizumab for cerebral radiation necrosis?

Gao,

Wang,

Wang

et al. 2023

Cancer Science

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Although intravenous bevacizumab (IVBEV) is the most promising treatment for cerebral radiation necrosis (CRN), there is no conclusion on the optimal dosage. Our retrospective study aimed to compare the efficacy and safety of high‐dose with low‐dose IVBEV in treating CRN associated with radiotherapy for brain metastases (BMs). This paper describes 75 patients who were diagnosed with CRN secondary to radiotherapy for BMs, treated with low‐dose or high‐dose IVBEV and followed up for a minimum of 6 months. The clinical data collected for this study include changes in brain MRI, clinical symptoms, and corticosteroid usage before, during, and after IVBEV treatment. At the 3‐month mark following administration of IVBEV, a comparison of two groups revealed that the median percentage decreases in CRN volume on T2‐weighted fluid‐attenuated inversion recovery and T1‐weighted gadolinium contrast‐enhanced image (T1CE), as well as the signal ratio reduction on T1CE, were 65.8% versus 64.8% (p = 0.860), 41.2% versus 51.9% (p = 0.396), and 37.4% versus 35.1% (p = 0.271), respectively. Similarly, at 6 months post‐IVBEV, the median percentage reductions of the aforementioned parameters were 59.5% versus 62.0% (p = 0.757), 39.1% versus 31.3% (p = 0.851), and 35.4% versus 28.2% (p = 0.083), respectively. Notably, the incidence of grade ≥3 adverse events was higher in the high‐dose group (n = 4, 9.8%) than in the low‐dose group (n = 0). Among patients with CRN secondary to radiotherapy for BMs, the administration of high‐dose IVBEV did not demonstrate superiority over low‐dose IVBEV. Moreover, the use of high‐dose IVBEV was associated with a higher incidence of grade ≥3 adverse events compared with low‐dose IVBEV.

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Low-Dosage Bevacizumab Treatment: Effect on Radiation Necrosis After Gamma Knife Radiosurgery for Brain Metastases

Cited by 5 publications

References 31 publications

Bevacizumab for the Treatment of Patients With Brain Radionecrosis

Bevacizumab for the Treatment of Patients With Brain Radionecrosis

Cognitive dysfunction induced by cranial radiotherapy: mechanisms and therapeutic methods

Can low‐dose intravenous bevacizumab be as effective as high‐dose bevacizumab for cerebral radiation necrosis?

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