Prophylactic Bevacizumab May Mitigate Radiation Injury: An Experimental Study

Aslan, Ayfer; Kaya, Züleyha; Bulduk, Erkut Baha; Öcal, Özgür; Uçar, Murat; Erpolat, Ozge Petek; Kaymaz, Figen; Börcek, Alp Özgün

doi:10.1016/j.wneu.2018.05.094

Cited by 11 publications

(7 citation statements)

References 30 publications

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“…At present, bevacizumab is regarded as a treatment that can be applied subsequent to RN diagnosis; whether it could also be used as a preventive treatment is rarely mentioned. A study including 54 adults male Wistar rats reported less severe RN in animals receiving prophylactic bevacizumab treatment before a 100-Gy radiation dosage (30). If further clinical research confirms these findings, it may be possible to consider bevacizumab as a preventive rather than purely treatment modality.…”

Section: Discussionmentioning

confidence: 95%

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

et al. 2021

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Cerebral radiation necrosis (RN), a complication of Gamma Knife radiosurgery, is difficult to treat, although bevacizumab seems to be effective. However, clinical data pertaining to bevacizumab treatment for RN are scarce, and its high price is problematic. This study explored the effectiveness of low-dose bevacizumab for RN caused by Gamma Knife. We retrospectively analyzed 22 patients who suffered cerebral RN post-Gamma Knife, and received bevacizumab treatment because of the poor efficacy of glucocorticoids. Low-dose bevacizumab (3 mg/kg) was administered for two cycles at 2-week intervals. T1- and T2-enhanced magnetic resonance imaging (MRI) images were examined for changes in RN status. We also monitored the dose of glucocorticoid, Karnofsky Performance Status (KPS) score, and adverse drug reactions. The mean volume of RN lesions decreased by 45% on T1-weighted images with contrast enhancement, and by 74% on T2-weighted images. All patients discontinued the use of glucocorticoids. According to the KPS scores, all patients showed an improvement in their symptoms and neurological function. No side effects were observed. Low-dosage bevacizumab at a dose of 3 mg/kg every 2 weeks is effective for treating cerebral RN after Gamma knife for brain metastases.

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Section: Discussionmentioning

confidence: 95%

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

et al. 2021

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“…The use of bevacizumab, targeting vascular endothelial growth factor, often at lower doses and for a small number of administrations, has proven to be an extremely valuable therapy that can lead to fairly rapid improvement in edema, reduction in contrast uptake, and improvement in symptoms. 2,5,9 Concerns remain related to possible side effects. It is also relatively expensive.…”

Section: Adverse Radiation Effectsmentioning

confidence: 99%

Current and novel practice of stereotactic radiosurgery

Kondziolka¹

2019

Journal of Neurosurgery

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Stereotactic radiosurgery emerged as a neurosurgical discipline in order to utilize energy for the manipulation of brain or nerve tissue, with the goal of minimal access and safe and effective care of a spectrum of neurosurgical disorders. Perhaps no other branch of neurosurgery has been so disruptive across the entire discipline of brain tumor care, treatment of vascular disorders, and management of functional problems. Radiosurgery is mainstream, supported by thousands of peer-reviewed outcomes reports. This article reviews current practice with a focus on challenges, emerging trends, and areas of investigation.

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“…BEV may also have a corticosteroid-sparing effect, but up to now this has been only observed in primary brain tumor trials [81]. Animal models' studies and case reports indicate that BEV has a potential role in mitigating and treating radiation necrosis [82–84].…”

Section: Antiangiogenic Agentsmentioning

confidence: 99%

From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC

Protopapa

Kouloulias

Nikoloudi

et al. 2019

Journal of Oncology

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Non-small cell lung cancer patients with brain metastases have a multitude of treatment options, but there is currently no international and multidisciplinary consensus concerning their optimal treatment. Local therapies have the principal role, especially in symptomatic patients. Advances in surgery and radiation therapy manage considerable local control. Systemic treatments have shown effect in clinical trials and in real life clinical settings; yet, at present, this is restricted to patients with asymptomatic or stable intracranial lesions. Targeted agents can have a benefit only in patients with EGFR mutations or ALK rearrangement. Immunotherapy has shown impressive results in patients with PD-L1 expression in tumor cells. Its effects can be further enhanced by a synergy with radiotherapy, possibly by increasing the percentage of responders. The present review summarizes the need for more effective systemic treatments, so that the increased intracranial control achieved by local treatments can be translated in an increase in overall survival.

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Prophylactic Bevacizumab May Mitigate Radiation Injury: An Experimental Study

Cited by 11 publications

References 30 publications

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

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

Current and novel practice of stereotactic radiosurgery

From Whole-Brain Radiotherapy to Immunotherapy: A Multidisciplinary Approach for Patients with Brain Metastases from NSCLC

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