Efficacy and safety of bevacizumab treatment for refractory brain edema: Case report

Objective:This retrospective study investigated the efficacy and safety of bevacizumab treatment for refractory brain edema.Methods:Between March 2009 and December 2015, bevacizumab was used to treat 59 cases of brain metastatic patients with refractory brain edema. The median dose of bevacizumab was 4.68mg/kg (range 2.8-6.52mg/kg). The clinical-pathological data, the efficacy, and the side effects of bevacizumab were recorded. Magnetic resonance imaging (MRI) was performed before and after bevacizumab treatment. Tumor and edema volumes were measured separately.Results:The clinical symptoms of 50 out of 59 cases (84.74%) improved the day after the bevacizumab treatment, and the edema volumes of 55 (93.22%) cases were reduced after the bevacizumab treatment. The average edema volume was significantly reduced after bevacizumab treatment from 125,583.4314,093.27 to 71,613.42 +/- 9473.42mm(3) (Mann-Whitney rank test, P<.01), and the average edema index was significantly reduced from 25.66 +/- 11.54 to 17.87 +/- 6.87 (Mann-Whitney rank test, P<.01). One patient died from a hemorrhage due to a cancerous-ulcer of the maxillary sinus. The main complication observed was hypertension, which was observed in 11 cases (18.6%).Conclusion:The effective rate of bevacizumab for refractory brain edema is 84.74%. Hypertension was the main side effect of the bevacizumab treatment. Bevacizumab is an effective and relatively safe treatment for brain edema.