Zhuang Hongqing, Yuan Xiangkun, Yuan Zhiyong, Wang Ping
Department of Radiotherapy, Peking University Third Hospital, Beijing. China.
Department of Radiochemotherapy, Hebei Province Cangzhou Hospital of Integrated Traditional and Western Medicine, Hebei. China.
Recent Pat Anticancer Drug Discov. 2017;12(3):272-277. doi: 10.2174/1574892812666170425124430.
The effect of bevacizumab (BVZ) for Cerebral Radiation Necrosis (CRN) was clear. However, the indications of BVZ had no reports.
The aim of the paper was to investigate the indications of BVZ for CRN.
Fourteen CRN patients (confirmed by imaging diagnosis) who underwent BVZ treatment between June 2011 and December 2014 were analyzed. BVZ was administered (5mg/kg body weight) once every three to four weeks for at least three cycles. Contrast-enhanced T1 MRI signal intensity changes were measured after BVZ treatment, to evaluate the clinical efficacy of BVZ and the recurrence and progression of CRN. Three patients who were followed for a longer duration were described in detail. The main observations included the indications and (the) use of BVZ for CRN.
Most patients undergoing BVZ treatment for CRN exhibited recurrence. One of the three patients described in detail was asymptomatic; CRN was reduced but then progressed, and a second course of BVZ failed. The other two patients showed obvious symptoms of primary CRN; CRN was significantly reduced, but then progressed with mild symptoms. A second short course of BVZ showed poor efficacy in one patient who demonstrated long-term stability after BVZ withdrawal. Second long course of BVZ resulted in further aggravation of CRN in the other patient, and a re-examination revealed spontaneous remission of CRN.
Symptoms are an indication of BVZ treatment for primary CRN.
贝伐单抗（BVZ）治疗脑放射性坏死（CRN）的效果明确。然而，BVZ的适应证尚无报道。
本文旨在探讨BVZ治疗CRN的适应证。
分析2011年6月至2014年12月期间接受BVZ治疗的14例CRN患者（经影像学诊断确诊）。BVZ按5mg/kg体重给药，每三至四周给药一次，至少给药三个周期。在BVZ治疗后测量对比增强T1加权磁共振成像（MRI）信号强度变化，以评估BVZ的临床疗效以及CRN的复发和进展情况。详细描述了3例随访时间较长的患者。主要观察指标包括BVZ治疗CRN的适应证及应用情况。
大多数接受BVZ治疗的CRN患者出现复发。详细描述的3例患者中，1例无症状；CRN有所减轻但随后进展，再次使用BVZ治疗无效。另外2例患者表现出原发性CRN的明显症状；CRN显著减轻，但随后出现轻微症状进展。在1例患者中，第二次短期使用BVZ疗效不佳，该患者在停用BVZ后病情长期稳定。在另1例患者中，第二次长期使用BVZ导致CRN进一步加重，复查发现CRN自发缓解。
症状是BVZ治疗原发性CRN的适应证。
