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Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma
Published on: October 27, 2014
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Bevacizumab for pediatric radiation necrosis
Lorena V Baroni1,2,3, Daniel Alderete1,2, Palma Solano-Paez4
1Division of Haematology/Oncology, Hospital for Sick Children, Toronto, ON, Canada.
Neuro-Oncology Practice
|August 9, 2020
Summary
Bevacizumab effectively treated radiation necrosis in children, reducing steroid use and showing clinical and radiological improvement in 50% of patients. This anti-VEGF therapy was well-tolerated, warranting further pediatric clinical trials.
Area of Science:
- Pediatric Oncology
- Radiation Oncology
- Neurology
Background:
- Radiation necrosis is a common, challenging complication after pediatric brain tumor treatment.
- Bevacizumab, an anti-VEGF antibody, shows promise in adults but is understudied in children.
Purpose of the Study:
- To evaluate the efficacy and safety of bevacizumab for symptomatic radiation necrosis in pediatric patients.
- To assess bevacizumab's impact on steroid usage and clinical/radiological outcomes.
Main Methods:
- Retrospective review of 26 pediatric patients treated with bevacizumab for radiation necrosis across 5 institutions.
- Inclusion of patients treated after initial irradiation and reirradiation.
Main Results:
- 50% of patients (13/26) experienced objective clinical improvement.
- Radiological improvement was observed in 50% of patients, with reduced T2/FLAIR signal and mass effect.
- Bevacizumab was well-tolerated, enabling corticosteroid dose/duration reduction in most patients; only 1 patient had significant hypertension.
Conclusions:
- Bevacizumab is an effective and well-tolerated treatment for symptomatic radiation necrosis in children.
- Further investigation in controlled clinical trials is recommended to confirm these findings.
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