Case Reports:

Exploration of the recurrence in radiation brain necrosis after bevacizumab discontinuation

Hongqing Zhuang _, Xiangkun Yuan, Joe Y. Chang, Yongchun Song, Junjie Wang, Zhiyong Yuan, Xiaoguang Wang and Ping Wang

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Oncotarget. 2016; 7:48842-48849. https://doi.org/10.18632/oncotarget.7768

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Hongqing Zhuang1, Xiangkun Yuan2, Joe Y. Chang3, Yongchun Song1, Junjie Wang4, Zhiyong Yuan1, Xiaoguang Wang1 and Ping Wang1

1 Department of Radiotherapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, China

2 Department of Radiotherapy, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine (Cangzhou No. 2 Hospital), Hebei, China

3 Department of Radiation Oncology, Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America

4 Department of Radiotherapy, Peking University 3rd Hospital, Beijing, China

Correspondence to:

Hongqing Zhuang, email:

Keywords: bevacizumab, brain necrosis, recurrence

Received: November 27, 2015 Accepted: February 08, 2016 Published: February 26, 2016


Objective: The aim of the paper was to investigate the recurrence and its causes of radiation brain necrosis following bevacizumab discontinuation. Methods: This study included 14 patients with radiation brain necrosis (confirmed through imaging) after stereotactic radiotherapy for a primary or metastatic brain tumor and who received bevacizumab treatment from June 2011 through December 2014. The patients received bevacizumab at 5 mg/kg, q3-4w, for at least 3 cycles. The T1 signal intensity from enhanced MRI images was used as the evaluation criteria for the brain necrosis treatment efficacy. Results: brain necrosis improved in 13 of the 14 cases (92.9%). However, during follow-up, 10 of the 13 responsive patients (76.9%) exhibited a recurrence in brain necrosis, and a multiple linear regression analysis shows that brain necrosis recurrence was related to the follow-up time after the initial bevacizumab treatment discontinuation. Conclusion: bevacizumab produced good short-term effects for radiation brain necrosis; however, most of the patients would recurrence after bevacizumab is discontinued. Thus, brain necrosis was irreversible.

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