Abstract | BACKGROUND AND PURPOSE: Recently two retrospective cohort studies report efficacy of bevacizumab in patients with recurrent atypical and anaplastic meningioma. Another successful therapeutic option of bevacizumab seems to be treatment of cerebral radiation necrosis. However, the antiangiogenic effects in MRI diffusion and perfusion in meningiomas have not been previously described in detail. The objective of this research was to evaluate the clinical and MR imaging effects of bevacizumab in a malignant meningioma patient harboring additional cerebral radiation necrosis. CASE PRESENTATION: We report the case of an 80-year-old woman who underwent bevacizumab therapy (5 mg/kg every 2 weeks for 2 months) for treatment of a symptomatic radiation necrosis in malignant meningiomatosis of World Health Organization (WHO) grade III. The patient was closely monitored with MRI including diffusion and perfusion studies. Upon bevacizumab therapy, the clinical situation was well stabilized over a period of 4 months until the patient unfortunately died due to pneumonia/ septicemia probably unrelated to bevacizumab therapy. Consecutive MRI demonstrated 4 important aspects: (1) considerable decrease of the contrast medium (CM)-enhanced radiation necrosis, (2) mixed response with respect to the meningiomatosis with stable and predominantly growing tumor lesions, (3) a new diffusion-weighted imaging (DWI) lesion in a CM-enhanced tumor as described in gliomas, which we did not interpret as a response to bevacizumab therapy, and (4) new thrombembolic infarcts, which are a known side-effect of bevacizumab treatment. CONCLUSION:
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Authors | J P Boström, M Seifert, S Greschus, N Schäfer, M Glas, G Lammering, U Herrlinger |
Journal | Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
(Strahlenther Onkol)
Vol. 190
Issue 4
Pg. 416-21
(Apr 2014)
ISSN: 1439-099X [Electronic] Germany |
PMID | 24429478
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Angiogenesis Inhibitors
- Antibodies, Monoclonal, Humanized
- Bevacizumab
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Topics |
- Aged, 80 and over
- Angiogenesis Inhibitors
(therapeutic use)
- Antibodies, Monoclonal, Humanized
(therapeutic use)
- Bevacizumab
- Brain Injuries
(drug therapy, pathology)
- Diffusion Magnetic Resonance Imaging
(methods)
- Female
- Humans
- Magnetic Resonance Angiography
(methods)
- Meningeal Neoplasms
(pathology, therapy)
- Meningioma
(pathology, therapy)
- Radiation Injuries
(drug therapy, pathology)
- Radiotherapy, Conformal
(adverse effects)
- Treatment Outcome
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