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Case Reports
. 2024 Sep 4:15:1401000.
doi: 10.3389/fphar.2024.1401000. eCollection 2024.

The efficacy of stereotactic radiotherapy followed by bevacizumab and temozolomide in the treatment of recurrent glioblastoma: a case report

Wangyan Zhong  1 , Jiwei Mao  1 , Dongping Wu  1 , Jianghua Peng  2 , Wanli Ye  1
Affiliations
Case Reports

The efficacy of stereotactic radiotherapy followed by bevacizumab and temozolomide in the treatment of recurrent glioblastoma: a case report

Wangyan Zhong et al. Front Pharmacol. .

Abstract

Glioblastoma (GBM) is the most common and aggressive malignant brain tumor among adults. Despite advancements in multimodality therapy for GBM, the overall prognosis remains poor, with an extremely high risk of recurrence. Currently, there is no established consensus on the optimal treatment option for recurrent GBM, which may include reoperation, reirradiation, chemotherapy, or a combination of the above. Bevacizumab is considered a first-line treatment option for recurrent GBM, as is temozolomide. However, in recurrent GBM, it is necessary to balance the risks and benefits of reirradiation in combination with bevacizumab and temozolomide. Herein, we report the case of a patient with recurrent GBM after standard treatment who benefited from stereotactic radiotherapy followed by bevacizumab and temozolomide maintenance therapy. Following 16 months of concurrent chemoradiotherapy (CCRT), the patient was diagnosed with recurrent GBM by a 3-T contrast-enhanced magnetic resonance imaging (MRI). The addition of localized radiotherapy to the ongoing treatment regimen of bevacizumab, in combination with temozolomide therapy, prolonged the patient's disease-free survival to over 2 years, achieving a significant long-term outcome, with no notable adverse effects observed. This clinical case may provide a promising new option for patients with recurrent GBM.

Keywords: bevacizumab; combination therapy; recurrent glioblastoma; stereotactic radiotherapy; temozolomide.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Diagnosis of Glioblastoma. Axial (A), coronal (B) and sagittal (C) Diagnostic imaging result. T1-weighted MRI demonstrating a contrast-rim-enhancing lesion of the right temporal lobe. (D) Hematoxylin and eosin stains of the tumor, showing vascular endothelial cell proliferation at 100x.
FIGURE 2
FIGURE 2
Timeline of treatment and radiographic responses. (A) Timeline of treatment. Abbreviations: Glioblastoma (GBM), partial response (PR), complete response (CR), bevacizumab (BEV), temozolomide (TMZ), stereotactic radiotherapy (SRT); (B, C) The post-contrast T1-weighted MRI showing regression of the lesion and demonstrating the effectiveness of SRT followed by bevacizumab (BEV) and temozolomide (TMZ).
See this image and copyright information in PMC

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