Effect of bevacizumab on radiation necrosis of the brain

Antiangiogenic Strategies for Treatment of Malignant Gliomas

“…51 In addition, a recent retrospective series suggested that bevacizumab was effective in reducing radiation necrosis. 52 There is increasing awareness that standard treatment with concurrent chemotherapy and radiation may increase the risk of pseudoprogression, tumor necrosis, and edema. [53][54][55] Further development of antiangiogenic therapy for the treatment of tumor edema and necrosis may be warranted, given that corticosteroids (the most common agents used to treat these indications) are associated with considerable adverse effects.…”

Exploration of the Recurrence of Radiation Brain Necrosis After Bevacizumab Discontinuation

“…However, bevacizumab is an anti-angiogenic drug recognized for its role in pruning vessels and promoting blood supply, which is inconsistent with the above inference [25]. We believe that several mechanisms are [26].Among many previous studies, only a few have reported several recurrence cases [4][5][6][7][8][9][10]. Our literature review shows that previous researchers may have missed progression in many cases reported as "without progression" due to individual differences in bevacizumab sensitivity, short follow-up times after bevacizumab is discontinued, or death shortly after bevacizumab is discontinued.…”

“…Compared to previous reports, most studies [4][5][6][7][8][9][10] only reported the efficacy of bevacizumab in the treatment of radiation-induced cerebral necrosis, while there were fewer studies on the recurrence and progression of radiation-induced cerebral necrosis after treatment. No studies have yet explored the reasons for recurrence and progression.…”

“…Many clinical studies have shown that bevacizumab produces good shortterm effects on radiation brain necrosis [4][5][6][7][8][9][10][11].However, few studies have reported on radiation brain necrosis progression following bevacizumab discontinuation, and the causes of such progression have not been studied. To provide a reference for clinical treatment, we statistically analyzed bevacizumab treatment efficacy in patients with radiation brain necrosis treated at the Tianjin Cancer Hospital and their progression after bevacizumab discontinuation.…”

Role of MRI in Primary Brain Tumor Evaluation

“…Evidence suggests that increased levels of VEGF contribute to leaky vasculature in radiation necrosis, and bevacizumab substantially improves the radiographic appearance by decreasing enhancement and edema. 6 Furthermore, pseudoprogression, a subacute radiation effect, is estimated to occur in 20% to 30% of patients with glioblastoma in whom the first postradiation MRI shows an increase in contrast enhancement that subsides with time without intervention. 7,8 This phenomenon likely results from transiently increased permeability of the tumor vasculature from irradiation, and its imaging appearance could potentially improve in the presence of bevacizumab.…”