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01-12-2013 | Topic Review

Bevacizumab for radiation necrosis following treatment of high grade glioma: a systematic review of the literature

Authors: Daniel Lubelski, Kalil G. Abdullah, Robert J. Weil, Nicholas F. Marko

Published in: Journal of Neuro-Oncology | Issue 3/2013

Abstract

This review identifies the current literature on the use of bevacizumab for cerebral radiation necrosis in patients with high-grade gliomas, summarizes the clinical course and complications following bevacizumab, and discusses the relative costs and benefits of this therapeutic option. A Medline search was conducted of all clinical studies before September 2012 investigating outcomes following use of bevacizumab therapy for radiation necrosis in patients with high-grade gliomas. Clinical and radiographic outcomes are reviewed. Seven studies reported a total of 30 patients with high-grade gliomas treated with bevacizumab for radiation necrosis. All patients demonstrated decreased radiographic volume of edema on T1 and T2 MRI sequences. Clinical outcomes were reported for 23 patients: 16 (70 %) had improvement in neurologic signs or symptoms, 5 (22 %) had mixed results, and 2 (9 %) remained neurologically unchanged. Complications were documented in 5 of 7 studies (18 of 29 patients, 62 %) and included deep vein thrombosis, pulmonary embolism, visual field worsening, worsening hemiplegia, pneumonia, seizure, and fatigue. Only one study evaluated quality of life measures and none evaluated cost or cost effectiveness. Data regarding the use of bevacizumab to treat radiation necrosis in patients with high-grade gliomas is limited and primarily class III evidence. While bevacizumab improves neurological symptoms and reduces radiographic volume of necrosis-associated cerebral edema, it comes at the expense of a high rate of potentially serious complications. Definitive evidence for the utility, cost-effectiveness, and overall efficacy of this management strategy is currently lacking and additional investigation is warranted.

Stupp R, Mason WP, Van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352(10):987–996PubMedCrossRef

Siu A, Wind JJ, Iorgulescu JB et al (2012) Radiation necrosis following treatment of high grade glioma—a review of the literature and current understanding. Acta Neurochir (Wien) 154(2):191–201 discussion 201CrossRef

Giglio P, Gilbert MR (2003) Cerebral radiation necrosis. Neurologist 9(4):180–188PubMedCrossRef

Chin LS, Ma L, DiBiase S (2001) Radiation necrosis following gamma knife surgery: a case-controlled comparison of treatment parameters and long-term clinical follow up. J Neurosurg 94(6):899–904PubMedCrossRef

Brandsma D, Stalpers L, Taal W, Sminia P, Van den Bent MJ (2008) Clinical features, mechanisms, and management of pseudoprogression in malignant gliomas. Lancet Oncol 9(5):453–461PubMedCrossRef

Chamberlain MC, Glantz MJ, Chalmers L, Van Horn A, Sloan AE (2007) Early necrosis following concurrent Temodar and radiotherapy in patients with glioblastoma. J Neurooncol 82(1):81–83PubMedCrossRef

Fink J, Born D, Chamberlain MC (2011) Pseudoprogression: relevance with respect to treatment of high-grade gliomas. Curr Treat Options Oncol 12(3):240–252PubMedCrossRef

Brandes AA, Tosoni A, Spagnolli F et al (2008) Disease progression or pseudoprogression after concomitant radiochemotherapy treatment: pitfalls in neurooncology. Neuro Oncol 10(3):361–367PubMedCrossRef

Ruben JD, Dally M, Bailey M et al (2006) Cerebral radiation necrosis: incidence, outcomes, and risk factors with emphasis on radiation parameters and chemotherapy. Int J Radiat Oncol Biol Phys 65(2):499–508PubMedCrossRef

10.

Wang Y, Pan L, Sheng X et al (2012) Reversal of cerebral radiation necrosis with bevacizumab treatment in 17 Chinese patients. Eur J Med Res 17(1):25PubMedCrossRef

11.

Drappatz J, Schiff D, Kesari S, Norden AD, Wen PY (2007) Medical management of brain tumor patients. Neurol Clin 25(4):1035–1071, ix

12.

Hart GB, Mainous EG (1976) The treatment of radiation necrosis with hyperbaric oxygen (OHP). Cancer 37(6):2580–2585PubMedCrossRef

13.

Chuba PJ, Aronin P, Bhambhani K et al (1997) Hyperbaric oxygen therapy for radiation-induced brain injury in children. Cancer 80(10):2005–2012PubMedCrossRef

14.

Kohshi K, Imada H, Nomoto S et al (2003) Successful treatment of radiation-induced brain necrosis by hyperbaric oxygen therapy. J Neurol Sci 209(1–2):115–117PubMedCrossRef

15.

Bui Q-C, Lieber M, Withers HR et al (2004) The efficacy of hyperbaric oxygen therapy in the treatment of radiation-induced late side effects. Int J Radiat Oncol Biol Phys 60(3):871–878PubMedCrossRef

16.

Glantz MJ, Burger PC, Friedman AH et al (1994) Treatment of radiation-induced nervous system injury with heparin and warfarin. Neurology 44(11):2020–2027PubMedCrossRef

17.

Gonzalez J, Kumar AJ, Conrad CA, Levin VA (2007) Effect of bevacizumab on radiation necrosis of the brain. Int J Radiat Oncol Biol Phys 67(2):323–326PubMedCrossRef

18.

Levin VA, Bidaut L, Hou P et al (2011) Randomized double-blind placebo-controlled trial of bevacizumab therapy for radiation necrosis of the central nervous system. Int J Radiat Oncol Biol Phys 79(5):1487–1495PubMedCrossRef

19.

Matuschek C, Bölke E, Nawatny J et al (2011) Bevacizumab as a treatment option for radiation-induced cerebral necrosis. Strahlenther Onkol 187(2):135–139PubMedCrossRef

20.

Arratibel-Echarren I, Albright K, Dalmau J, Rosenfeld MR (2011) Use of bevacizumab for neurological complications during initial treatment of malignant gliomas. Neurologia 26(2):74–80PubMedCrossRef

21.

Torcuator R, Zuniga R, Mohan YS et al (2009) Initial experience with bevacizumab treatment for biopsy confirmed cerebral radiation necrosis. J Neurooncol 94(1):63–68PubMedCrossRef

22.

Furuse M, Kawabata S, Kuroiwa T, Miyatake S-I (2011) Repeated treatments with bevacizumab for recurrent radiation necrosis in patients with malignant brain tumors: a report of 2 cases. J Neurooncol 102(3):471–475PubMedCrossRef

23.

Gronier S, Bourg V, Frenay M et al (2011) Bevacizumab for the treatment of cerebral radionecrosis. Rev Neurol (Paris) 167(4):331–336CrossRef

24.

Thompson EM, Frenkel EP, Neuwelt EA (2011) The paradoxical effect of bevacizumab in the therapy of malignant gliomas. Neurology 76(1):87–93PubMedCrossRef

25.

Kelly PJ, Dinkin MJ, Drappatz J, O’Regan KN, Weiss SE (2011) Unexpected late radiation neurotoxicity following bevacizumab use: a case series. J Neurooncol 102(3):485–490PubMedCrossRef

26.

Sherman JH, Aregawi DG, Lai A et al (2009) Optic neuropathy in patients with glioblastoma receiving bevacizumab. Neurology 73(22):1924–1926PubMedCrossRef

27.

Galanis E, Anderson SK, Lafky JM, Uhm J, Giannini C, Kumar SK et al (2013) Phase II study of bevacizumab in combination with sorafenib in recurrent glioblastoma (N0776): A North Central Cancer Treatment Group Trial. Clin Cancer Res. doi:10.1158/1078-0432.CCR-13-0708 PubMed

28.

Fleming T (ed) (2007) Red book: pharmacy’s fundamental reference, 111th ed. Thomson, Belmont

29.

Shiroiwa T, Sung Y-K, Fukuda T et al (2010) International survey on willingness-to-pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness? Health Econ 19(4):422–437PubMedCrossRef

30.

Dropcho EJ (2012) Should the cost of care for patients with glioblastoma influence treatment decisions? Continuum (Minneap Minn) 18(2):416–420CrossRef

Title: Bevacizumab for radiation necrosis following treatment of high grade glioma: a systematic review of the literature
Authors: Daniel Lubelski
Kalil G. Abdullah
Robert J. Weil
Nicholas F. Marko
Publication date: 01-12-2013
Publisher: Springer US
Published in: Journal of Neuro-Oncology / Issue 3/2013
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-013-1233-0

At a glance: The STEP trials

Springer Medicine

Bevacizumab for radiation necrosis following treatment of high grade glioma: a systematic review of the literature

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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