Therapeutic effect of different doses of bevacizumab on radiation brain necrosis / 中华放射医学与防护杂志

ABSTRACT

Objective To evaluate the efficacy and safety of bevacizumab in the treatment of radiation brain necrosis, and to provide guidance for rational clinical application. Methods A retrospective analysis was made of 14 patients with radiation brain necrosis who had failed to receive mannitol and hormone treatment or had been treated for the first time. All the patients were divided into two groups according to different treatment regimens (5. 0 mg/ kg repeated every 14 d and 7. 5 mg/ kg repeated every 21 d). The changes of enhanced lesions in MRI T1W1 phase and edema in T2W1 phase were compared separately in the two groups. The clinical symptoms, changes of KPS score and adverse drug reactions were recorded. Results Totally 14 patients completed at least two cycles of treatment. After two cycles of treatment, the KPS scores of both groups were improved. The KPS scores of 5. 0 mg/ kg group were increased by 31. 66 points on average compared with those before treatment. The KPS scores of 7. 5 mg/ kg group were increased by 27. 50 points on average compared with those before treatment. The volume of CRN lesions were decreased (46. 0±9. 4)％ (t = 6. 57, P<0. 05) and the volume of edema lesions decreased (68. 9±8. 9)％ (t= 3. 32, P<0. 05) in 5. 0 mg/ kg group. In 7. 5 mg/ kg group, these two parameters were reduced by (53. 9±10. 7)％ (t = 7. 89, P<0. 05 and (77. 1±14. 3)％ (t = 4. 22, P<0. 05), respectively. There was no significant difference in the reduction of the mean volume of CRN lesions and the volume of edema area between the two groups (P>0. 05). In this study, the incidence of adverse events in the 5. 0 mg/ kg group was similar to that in the 7. 5 mg/ kg group, with no significant difference (P> 0. 05). Conclusions Bevacizumab can significantly improve the clinical symptoms and quality of life of patients with radiation brain necrosis. The safety of 5. 0 mg/ kg treatment regimen repeated every 14 d is similar to that of 7. 5 mg/ kg treatment regimen repeated every 21 d, which can be used for reference in the treatment of CRN.