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. 2023 Nov;14(31):3133-3139.
doi: 10.1111/1759-7714.15106. Epub 2023 Sep 17.

Bevacizumab reduces peritumoral brain edema in lung cancer brain metastases after radiotherapy

Yi-Chun Hua  1 , De-Zhi Gao  2 , Kuan-Yu Wang  2 , Xiao-Sheng Ding  1 , Wei-Ran Xu  1 , Yu-Bin Li  1 , Wei-Wei Shi  3 , Shi-Bin Sun  2 , Xiao-Yan Li  1
Affiliations

Bevacizumab reduces peritumoral brain edema in lung cancer brain metastases after radiotherapy

Yi-Chun Hua et al. Thorac Cancer. 2023 Nov.

Abstract

Background: The aim of this study was to investigate the efficacy of bevacizumab (Bev) in reducing peritumoral brain edema (PTBE) after stereotactic radiotherapy (SRT) for lung cancer brain metastases.

Methods: A retrospective analysis was conducted on 44 patients with lung cancer brain metastases (70 lesions) who were admitted to our oncology and Gamma Knife center from January 2020 to May 2022. All patients received intracranial SRT and had PTBE. Based on treatment with Bev, patients were categorized as SRT + Bev and SRT groups. Follow-up head magnetic resonance imaging was performed to calculate PTBE and tumor volume changes. The edema index (EI) was used to assess the severity of PTBE. Additionally, the extent of tumor reduction and intracranial progression-free survival (PFS) were compared between the two groups.

Results: The SRT + Bev group showed a statistically significant difference in EI values before and after radiotherapy (p = 0.0115), with lower values observed after treatment, but there was no difference in the SRT group (p = 0.4008). There was a difference in the distribution of EI grades in the SRT + Bev group (p = 0.0186), with an increased proportion of patients at grades 1-2 after radiotherapy, while there was no difference in the SRT group (p > 0.9999). Both groups demonstrated a significant reduction in tumor volume after radiotherapy (p < 0.05), but there was no difference in tumor volume changes between the two groups (p = 0.4089). There was no difference in intracranial PFS between the two groups (p = 0.1541).

Conclusion: Bevacizumab significantly reduces the severity of PTBE after radiotherapy for lung cancer. However, its impact on tumor volume reduction and intracranial PFS does not reach statistical significance.

Keywords: bevacizumab; brain metastases; lung cancer; peritumoral brain edema; radiotherapy.

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Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart.
FIGURE 2
FIGURE 2
(a) The values of EI (edema index) before and after radiotherapy in the SRT + Bev group and the SRT group. (b) The grades of EI before and after radiotherapy in the SRT + Bev group and the SRT group. EIH, the value of edema index EI after SRT; EIPOST, grading of edema index EI after SRT; EIQ, the value of edema index EI before SRT; EIPRE, grading of edema index (EI) before SRT; No., number of patients.
FIGURE 3
FIGURE 3
(a) Changes in tumor volume before and after radiotherapy in SRT + Bev group and SRT group. (b) Difference in tumor volume between SRT + Bev group and SRT group. Δ tumor volume = pretreatment – post‐treatment tumor volume.
FIGURE 4
FIGURE 4
Intracranial mPFS in SRT + Bev group and SRT group. mPFS, median progression‐free survival.
See this image and copyright information in PMC

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