| Popis: |
BACKGROUND: Optimal management of recurrent high grade gliomas continues to be challenging, with Bevacizumab as one of the modalities increasingly used in the last few years. The current audit looks at the pattern of use and its results from a major tertiary care center in India. METHODS: Patients who received Bevacizumab as salvage treatment for recurrent high grade glioma between January 2015 to August 2016 were included for this analysis. The demographics, characteristics at recurrence, symptomatic response, adverse events, and survival were noted. SPSS version 16 was used for analysis. Descriptive statistics was performed and Kaplan Meier time to event estimation method was used for estimation of progression free survival and overall survival. Results: Twenty seven patients were selected for this analysis. The median age was 47 years and 23 patients were males (85.1%). The histopathology was grade IV glioma in 21 patients (77.7%) and grade 3 in 6 patients (22.3%). Bevacizumab was used as 2nd line treatment in 22 patients, 3rd line in 4 patients and 4th line in 1 patient. It was administered as single agent in 11 patients and with chemotherapy in rest of the patients (CCNU in 2 patients and irinotecan in rest). The median number of cycles administered were 6 (1-12). Twenty two patients were eligible for symptomatic response assessment and 15 patients (68.1%) had symptomatic benefit. The median progression free survival was 145 days (57-232) and median overall survival was 164 days (123-204) respectively. The toxicity was limited to febrile neutropenia in 1 patient, bleeding episode in 1 patient and dyslipidemia in 1 patient. There was no episode of intracranial bleed or hypertension noted. There was a trend towards decrease in steroid use with bevacizumab. Conclusions: In Indian context Bevacizumab is well tolerated. Bevacizumab was associated with symptomatic improvement in recurrent high grade glioma. The ability of this drug to improve survival still remains questionable. |
