High-dose bevacizumab for radiation-induced brain necrosis: a case report

Abstract

Radiation-induced brain necrosis (RIBN) is a common adverse event from radiation therapy. We present a case of a 56-year-old man, diagnosed with non-small-cell lung cancer with brain metastases 2 years prior, for which he had received whole brain radiotherapy and brain stereotactic radiosurgery, who presented to the oncology unit with headache, dizziness and abnormal gait. MRI of the brain revealed radiological worsening of a cerebellar mass, including edema and mass effect. After a multidisciplinary tumor board meeting, the patient was diagnosed with RIBN and received 4 cycles of high-dose bevacizumab, with complete symptom resolution and significant radiological response. We report the successful use of a high-dose, shorter-duration treatment protocol of bevacizumab for RIBN.

Bevacizumab reduces peritumoral brain edema in lung cancer brain metastases after radiotherapy

“…In recent years, several studies have confirmed the efficacy of bevacizumab in the treatment of radiation‐induced brain necrosis. 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 A comprehensive meta‐analysis involving 12 studies showed that bevacizumab is effective in treating radiation‐induced brain edema, leading to improved clinical symptoms and superior outcomes in comparison to the corticosteroid treatment. 12 However, the majority of these studies were conducted with limited sample sizes, 13 , 14 , 15 leaving several questions unanswered.…”