Bevacizumab for Radiation Induced Optic Neuritis Among Aggressive Residual/Recurrent Suprasellar Tumors: More Than a Mere Antineoplastic Effect

Abstract

Background: Angiogenesis and vascular endothelial growth factor (VEGF) have recently been implicated in animal and clinical models of radiation-induced optic nerve, retinal, and brain necrosis. Although there are isolated case reports of anti-VEGF therapy with bevacizumab for management of radiation-induced brain necrosis, there are little data defining its role in radiation-induced optic nerve damage.

Patients and methods: This study included patients with a sellar-suprasellar tumor who underwent intensity-modulated or Gamma Knife radiotherapy and developed radiation-induced optic neuritis (RION) refractory to 3 weeks of glucocorticoid therapy who received bevacizumab 5 mg/kg intravenously as initial dose, followed by subsequent doses of 10 mg/kg.

Results: Here we report 3 patients with sellar-suprasellar lesions undergoing conventional radiation therapy (2 cases) or Gamma Knife surgery (1 case) who had benefitted from anti-VEGF therapy following radiation-induced optic nerve damage.

Conclusions: Early bevacizumab therapy in steroid-refractory RION shows gratifying results.

Keywords: Bevacizumab; Radiation-induced optic neuritis; Vascular endothelial growth factor.