Wound healing complications in brain tumor patients on Bevacizumab.

Abstract

Bevacizumab (BEV) is commonly used for treating recurrent glioblastoma (GBM), and wound healing is a well-established adverse event. Retrospective analysis of GBM patients with and without wound healing complications while on BEV treatment is reported. 287 patients identified, majority were males (60 %) with median age of 52.5 years. 14 cases identified with wound healing problems, related to either craniotomy (n = 8) or other soft tissue wounds (n = 6). Median duration of BEV treatment to complication was 62 days (range 6-559). Majority received 10 mg/kg (n = 11) and nine (64.3 %) were on corticosteroids, with median daily dose of 6 mg (range 1-16 mg) for median of 473 days before starting BEV. For dehisced craniotomy wounds, median time for starting BEV from last surgery was 29 days (range 27-345). Median time from starting BEV to developing wound complication was 47 days (range 16-173). Seven (87.5 %) had infected wounds requiring antibiotics, hospitalization. Four (50 %) required plastic surgery. BEV stopped and safely resumed in 6 (75 %) patients; median delay was 70 days (range 34-346). Soft tissue wounds included decubitus ulcer, dehisced striae, herpes simplex, trauma to hand and back, and abscess. Median time from starting BEV to wound issues was 72 days (range 6-559). Five (83.3 %) were infected, requiring antibiotics. While three (50 %) required hospitalization, none required plastic surgery. Treatment stopped in five (83.3 %) and restarted in two (median delay 48 days, range 26-69). Wound healing complications are uncommon but associated with significant morbidity. Identifying those at risk and contributing factors warrants further investigation.

• Authors: Harshad Ladha, Tushar Pawar, Mark R Gilbert, Jacob Mandel, Barbara O-Brien, Charles Conrad, Margaret Fields, Teresa Hanna, Carolyn Loch, Terri S Armstrong
• Journal: Journal of neuro-oncology (J Neurooncol) Vol. 124 Issue 3 Pg. 501-6 (Sep 2015) ISSN: 1573-7373 [Electronic] United States
• PMID: 26298437 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Bevacizumab

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (therapeutic use)
• Bevacizumab (therapeutic use)
• Brain Neoplasms (drug therapy)
• Electronic Health Records (statistics & numerical data)
• Female
• Follow-Up Studies
• Glioblastoma (drug therapy)
• Humans
• Male
• Middle Aged
• Retrospective Studies
• Treatment Outcome
• Wound Healing (drug effects)
• Young Adult