Rescue bevacizumab following symptomatic pseudoprogression of a tectal glioma post-radiotherapy: a case report and review of the literature
| Autor: | Arun N E Sundaram, Arjun Sahgal, Timothy K. Nguyen, Sunit Das, Jay Detsky, Pejman Jabehdar Maralani, James Perry, Eirena Calabrese |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Neurology genetic structures Bevacizumab medicine.medical_treatment Angiogenesis Inhibitors 03 medical and health sciences Young Adult 0302 clinical medicine Glioma medicine Humans Radiation Injuries Pseudoprogression Dexamethasone Tectum Mesencephali business.industry Brain Neoplasms Astrocytoma medicine.disease Prognosis Radiation therapy Oncology Tumor progression 030220 oncology & carcinogenesis Disease Progression Neurology (clinical) Radiology Radiotherapy Intensity-Modulated business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Journal of neuro-oncology. 143(3) |
| ISSN: | 1573-7373 |
| Popis: | 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. 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. 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. Our findings support the potential use of bevacizumab as a rescue agent for symptomatic pseudoprogression. |
| Databáze: | OpenAIRE |
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