Bevacizumab as Therapy for Radiation Necrosis in Four Children With Pontine Gliomas

Journal Article · Sun Nov 15 00:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.12.032· OSTI ID:21367514

Macy, Margaret E; Foreman, Nicholas K ^[1]

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1. Children's Hospital, Denver, Department of Neuro-Oncology, Aurora, CO (United States)

Purpose: Diffuse pontine gliomas are a pediatric brain tumor that is fatal in nearly all patients. Given the poor prognosis for patients with this tumor, their quality of life is very important. Radiation therapy provides some palliation, but can result in radiation necrosis and associated neurologic decline. The typical treatment for this necrosis is steroid therapy. Although the steroids are effective, they have numerous side effects that can often significantly compromise quality of life. Bevacizumab, an antibody against vascular endothelial growth factor, has been suggested as a treatment for radiation necrosis. We report on our initial experience with bevacizumab therapy for radiation necrosis in pediatric pontine gliomas. Materials and Methods: Four children with pontine gliomas treated at the Children's Hospital in Denver and the University of Colorado Denver developed evidence of radiation necrosis both clinically and on imaging. Those 4 children then received bevacizumab as a treatment for the radiation necrosis. We reviewed the clinical outcome and imaging findings. Results: After bevacizumab therapy, 3 children had significant clinical improvement and were able to discontinue steroid use. One child continued to decline, and, in retrospect, had disease progression, not radiation necrosis. In all cases, bevacizumab was well tolerated. Conclusions: In children with pontine gliomas, bevacizumab may provide both therapeutic benefit and diagnostic information. More formal evaluation of bevacizumab in these children is needed.

• OSTI ID: 21367514
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 75, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2008.12.032; PII: S0360-3016(09)00031-5; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BRAIN
CHILDREN
GLIOMAS
MONOCLONAL ANTIBODIES
NECROSIS
RADIATION INJURIES
THERAPY
AGE GROUPS
ANIMALS
ANTIBODIES
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BODY
CENTRAL NERVOUS SYSTEM
DISEASES
INJURIES
MAMMALS
MAN
MEDICINE
NEOPLASMS
NERVOUS SYSTEM
NERVOUS SYSTEM DISEASES
ORGANS
PATHOLOGICAL CHANGES
PRIMATES
RADIATION EFFECTS
VERTEBRATES