{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:13:29Z","timestamp":1760015609659,"version":"3.40.5"},"reference-count":14,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:sec id=\"S0317167122000646_as1\"><jats:title>Background:<\/jats:title><jats:p>Cerebral radionecrosis, a subacute or late effect of radiotherapy, can be debilitating and difficult to treat. Steroids can reduce symptoms, but have significant long-term side effects. Bevacizumab has been shown to reduce edema and other radiologic features associated with radionecrosis and improve patient symptoms. We report our experience using bevacizumab for cerebral radionecrosis.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167122000646_as2\"><jats:title>Methods:<\/jats:title><jats:p>We retrospectively reviewed the charts of all patients treated at our institution with bevacizumab for non-glioma-associated cerebral radionecrosis. We recorded change in symptoms, change in steroids, change in performance status, time to tumor progression, and time to death. We delineated the volume of necrosis pre- and post-bevacizumab on T1-post-gadolinium and fluid-attenuated inversion recovery (FLAIR) MRI scans.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167122000646_as3\"><jats:title>Results:<\/jats:title><jats:p>We identified 15 patients, 8 with brain metastases, 6 with meningioma, and 1 with nasopharyngeal carcinoma. Most received four doses of bevacizumab, 7.5 mg\/kg q 3 weeks \u00d7 4 doses. Neuroimaging demonstrated a reduced T1 gadolinium-enhancing volume and edema in 14\/15 patients (the average reduction in T1-post-gadolinium volume was 3.0 cm<jats:sup>3<\/jats:sup>, and average reduction in FLAIR volume was 27.9 cm<jats:sup>3<\/jats:sup>). There was no appreciable change in patient performance status. Steroid doses decreased in five of nine patients. There was a high rate (26%) of adverse events, including pulmonary embolism, stroke, and wound dehiscence. The median progression-free survival was 6.5 months.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167122000646_as4\"><jats:title>Conclusion:<\/jats:title><jats:p>Although bevacizumab is commonly prescribed for cerebral radionecrosis, in our retrospective cohort, the clinical benefits were modest and there was significant toxicity.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cjn.2022.64","type":"journal-article","created":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T07:51:24Z","timestamp":1653897084000},"page":"573-578","source":"Crossref","is-referenced-by-count":9,"title":["Bevacizumab for Cerebral Radionecrosis: A Single-Center Experience"],"prefix":"10.1017","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4961-237X","authenticated-orcid":false,"given":"Seth A.","family":"Climans","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8484-2680","authenticated-orcid":false,"given":"Ronald C.","family":"Ramos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola A.","family":"Jablonska","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Shultz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Warren P.","family":"Mason","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,5,30]]},"reference":[{"key":"S0317167122000646_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2009.12.061"},{"key":"S0317167122000646_ref1","doi-asserted-by":"publisher","DOI":"10.1148\/rg.325125002"},{"key":"S0317167122000646_ref5","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/not085"},{"key":"S0317167122000646_ref7","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr2936e"},{"key":"S0317167122000646_ref12","doi-asserted-by":"publisher","DOI":"10.1097\/CMR.0000000000000389"},{"key":"S0317167122000646_ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.04.068"},{"key":"S0317167122000646_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2005.12.002"},{"key":"S0317167122000646_ref3","first-page":"1","article-title":"Hyperbaric oxygen for radiation necrosis of the brain","author":"Co","year":"2019","journal-title":"Can J Neurol Sci J Can Sci Neurol"},{"key":"S0317167122000646_ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-020-03570-0"},{"key":"S0317167122000646_ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-07889-3"},{"key":"S0317167122000646_ref9","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0b013e31829c3139"},{"key":"S0317167122000646_ref10","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2013-0107"},{"key":"S0317167122000646_ref11","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000003623"},{"key":"S0317167122000646_ref13","doi-asserted-by":"publisher","DOI":"10.1038\/srep24364"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167122000646","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T03:51:44Z","timestamp":1688010704000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167122000646\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,5,30]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,7]]}},"alternative-id":["S0317167122000646"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2022.64","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"type":"print","value":"0317-1671"},{"type":"electronic","value":"2057-0155"}],"subject":[],"published":{"date-parts":[[2022,5,30]]}}}