Journal
JAPANESE JOURNAL OF CLINICAL ONCOLOGY
Volume 43, Issue 3, Pages 337-341Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jjco/hys231
Keywords
bevacizumab; brain edema; Karnofsky performance status; positron emission tomography; radiation necrosis
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Funding
- JSPS [23592145]
- Grants-in-Aid for Scientific Research [23592146, 23592145, 24659658, 23390355] Funding Source: KAKEN
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Bevacizumab is effective in treating radiation necrosis; however, radiation necrosis was not definitively diagnosed in most previous reports. Here we used amino acid positron emission tomography to diagnose radiation necrosis for the application of bevacizumab in treating progressive radiation necrosis. Lesion/normal tissue ratios of 2.5 on (18)fluoride-labeled boronophenylalanine-positron emission tomography were defined as an indication of effective bevacizumab treatment. Thirteen patients were treated with bevacizumab at a dose of 5 mg/kg every 2 weeks. Two patients were excluded because of adverse events. The median reduction rate in perilesional edema was 65.5. Karnofsky performance status improved in six patients after bevacizumab treatment. Lesion/normal tissue ratios on (18)fluoride-labeled boronophenylalanine-positron emission tomography (P 0.0084) and improvement in Karnofsky performance status after bevacizumab treatment (P 0.0228) were significantly associated with reduced rates of perilesional edema. Thus, (18)fluoride-labeled boronophenylalanine-positron emission tomography could be useful for diagnosing radiation necrosis and predicting the efficacy of bevacizumab in progressive radiation necrosis.
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