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Journal of Neuro-Oncology
Published in: Journal of Neuro-Oncology 3/2019

01-07-2019 | Astrocytoma | Clinical Study

Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature

Authors: Timothy K. Nguyen, James Perry, Arun N. E. Sundaram, Jay Detsky, Pejman J. Maralani, Eirena Calabrese, Sunit Das, Arjun Sahgal

Published in: Journal of Neuro-Oncology | Issue 3/2019

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Abstract

Purpose

Radiation-induced pseudoprogression is a subacute clinical entity that is distinct from radiation necrosis and mimics tumor progression. Bevacizumab is a well-described treatment option for radiation necrosis, but its role in pseudoprogression is not clearly defined.

Methods

We report a case of radiation-induced pseudoprogression rescued with bevacizumab in a 20-year-old man with a biopsy-proven low-grade astrocytoma of the tectum. A review of the literature was also conducted specific to bevacizumab as a treatment for symptomatic pseudoprogression after radiotherapy for CNS tumors.

Results

This patient was treated with definitive intensity modulated stereotactic radiotherapy at a total dose of 54 Gy delivered in 30 daily fractions. Six weeks after radiotherapy the patient developed progressive headache, weakness and a documented deterioration in vision, which was accompanied by worsening of radiographic findings. A diagnosis of pseudoprogression was made and after limited benefit from a trial of dexamethasone, four cycles of bevacizumab were administered which resulted in rapid clinical and radiographic improvement.

Conclusions

Our findings support the potential use of bevacizumab as a rescue agent for symptomatic pseudoprogression.
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Metadata
Title
Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature
Authors
Timothy K. Nguyen
James Perry
Arun N. E. Sundaram
Jay Detsky
Pejman J. Maralani
Eirena Calabrese
Sunit Das
Arjun Sahgal
Publication date
01-07-2019
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 3/2019
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-019-03179-y

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