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Erschienen in:

03.05.2019 | Clinical Study

Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature

verfasst von: Timothy K. Nguyen, James Perry, Arun N. E. Sundaram, Jay Detsky, Pejman J. Maralani, Eirena Calabrese, Sunit Das, Arjun Sahgal

Erschienen in: Journal of Neuro-Oncology | Ausgabe 3/2019

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Abstract

Purpose

Radiation-induced pseudoprogression is a subacute clinical entity that is distinct from radiation necrosis and mimics tumor progression. Bevacizumab is a well-described treatment option for radiation necrosis, but its role in pseudoprogression is not clearly defined.

Methods

We report a case of radiation-induced pseudoprogression rescued with bevacizumab in a 20-year-old man with a biopsy-proven low-grade astrocytoma of the tectum. A review of the literature was also conducted specific to bevacizumab as a treatment for symptomatic pseudoprogression after radiotherapy for CNS tumors.

Results

This patient was treated with definitive intensity modulated stereotactic radiotherapy at a total dose of 54 Gy delivered in 30 daily fractions. Six weeks after radiotherapy the patient developed progressive headache, weakness and a documented deterioration in vision, which was accompanied by worsening of radiographic findings. A diagnosis of pseudoprogression was made and after limited benefit from a trial of dexamethasone, four cycles of bevacizumab were administered which resulted in rapid clinical and radiographic improvement.

Conclusions

Our findings support the potential use of bevacizumab as a rescue agent for symptomatic pseudoprogression.

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Titel: Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature
verfasst von: Timothy K. Nguyen
James Perry
Arun N. E. Sundaram
Jay Detsky
Pejman J. Maralani
Eirena Calabrese
Sunit Das
Arjun Sahgal
Publikationsdatum: 03.05.2019
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 3/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03179-y

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Abstract

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