Bevacizumab for Radiation-Induced (Radiculo)plexopathy.

Area of Science:

• Neurology
• Oncology
• Radiotherapy

Background:

• Radiation-induced plexopathy (RI(R)P) is a severe delayed complication in cancer survivors.
• Current treatment options for RI(R)P are limited.
• Bevacizumab, an anti-VEGF agent, is explored for RI(R)P treatment.

Purpose of the Study:

• To evaluate the efficacy of bevacizumab in treating radiation-induced plexopathy.
• To assess clinical, radiological, and neurophysiological outcomes in RI(R)P patients treated with bevacizumab.

Main Methods:

• Retrospective review of nine patients with contrast-enhancing RI(R)P treated under an expanded access program.
• Analysis of clinical, radiological, and neurophysiological data.
• Bevacizumab administered at 7.5 mg/kg every two weeks.

Main Results:

• Nine patients with neurophysiological-confirmed RI(R)P received bevacizumab.
• Median time from radiotherapy to treatment was 13 years.
• Clinical improvement in 3/9 patients, stabilization in 2/9.
• Early treatment (within 2 years of symptom onset) correlated with better outcomes.
• Reduced MRI enhancement was associated with clinical benefit.

Conclusions:

• Bevacizumab may be an effective treatment for radiation-induced plexopathy.
• Early intervention is crucial for optimal outcomes.
• Further prospective trials are needed to confirm these findings.