PDF(Pubmed)
Abstract：
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.
摘要：
尽管静脉注射贝伐单抗（IVBEV）是治疗脑放射性坏死（CRN）的最有希望的治疗方法，没有关于最佳剂量的结论。我们的回顾性研究旨在比较高剂量和低剂量IVBEV治疗与放疗相关的CRN脑转移瘤（BMs）的疗效和安全性。本文描述了75例被诊断为BMs放疗继发CRN的患者，用低剂量或高剂量IVBEV治疗，并随访至少6个月。本研究收集的临床数据包括脑部MRI的变化，临床症状,和皮质类固醇的使用之前，during,在IVBEV治疗后。在服用IVBEV后的3个月内，两组的比较显示，在T2加权流体衰减反转恢复和T1加权钆对比增强图像（T1CE）上，CRN体积的中位数百分比降低，以及T1CE上的信号比降低，分别为65.8%和64.8%(p=0.860)，41.2%对51.9%(p=0.396)，和37.4%对35.1%(p=0.271)，分别。同样，在IVBEV后6个月，上述参数的平均减少百分比为59.5%对62.0%(p=0.757)，39.1%对31.3%(p=0.851)，35.4%对28.2%(p=0.083)，分别。值得注意的是,高剂量组(n=4,9.8%)的≥3级不良事件发生率高于低剂量组(n=0).在BMs放疗继发CRN的患者中，与低剂量IVBEV相比,高剂量IVBEV的给药没有优势.此外，与低剂量IVBEV相比,高剂量IVBEV的使用与更高的≥3级不良事件发生率相关.
