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Table 3 Individual characteristics and treatment outcomes for RN patients

From: Bevacizumab for radiation necrosis following radiotherapy of brain metastatic disease: a systematic review & meta-analysis

Study Age Sex Primary histology Radiation Dose RN site Last RT to RN diagnosis RT to BV Tx BV dosage (mg/kg) No of treatments Treatment Duration (months) Volume reduction on T1W-Gd-enhanced MRI Volume reduction on T2W FLAIR MRI Pre-Tx KPS Post-Tx KPS KPS increase Pre-Tx Dex (mg) Post-Tx Dex (mg) Dex reduction (mg) Presenting Symptoms Improvement Adverse events
Wang, et al. (2012) [50] 70 M colon SRS 17 Gy L temporal   6     0 0 30 30 0 15 12.5 2.5   Improved  
71 M colon EBRT 36 Gy L frontal   4     65 10 40 80 40 15 5 10   Improved  
71 M Lung FSRT 31.5 Gy/3f L occipital   7     87 78 50 90 40 15 0 15   Improved  
67 F colon EBRT
SRS
39 Gy/10 f
16 Gy
R frontal   1     52 78 50 90 40 15 0 15   Worsened  
46 M Lung EBRT
SRS
30 Gy/13 f
16 Gy
L occipital   5     50 30 60 80 20 12.5 5 7.5   Improved  
Boothe, et al. (2013) [51] 58 M NSCLC WBRT
SRS
37.5
25/25
R frontal/L temporal    10q2w   2.3 38/64 3/36     8 0 8 None Improved  
50 F Breast SRS 30 R occipital    10q2w   2.3 82 75     2 0.3 1.7 Visual field disturbance, headaches Stable  
27 F Breast WBRT
SRS
37.5
18/21/21
L frontal/L temporal/R parietal    10q2w   1.4 38/64/91 70/67/63.5     4 0 4 Seizures Improved  
79 F NSCLC SRS 18 R parietal    10q2w   0.5 82 60     0.2 0 0.2 Lower left leg weakness Improved  
67 F Breast WBRT
SRS
30
18
Cerebellum    10q2w   14.3 73 72        Headaches, lower leg weakness Stable  
54 F Breast WBRT
SRS
37.5
15
R frontal    10q2w   3.9 21 44.6        Left arm weakness Improved  
67 M NSCLC SRS 30 R frontal    15q6w   2.8 10 3     24 0 24 Seizures, left sided weakness Improved  
50 F Breast WBRT
SRS
35
21
R frontal    7.5q3w   1.4 91 46     20 0 20 Fatigue, lethargy, facial asymmetry Improved  
67 F NSCLC SRS 21 L occipital    102w
4 w
   89 84.5     6 0 6 Confusions, visual hallucinations Stable  
73 M NSCLC SRS 21 L parietal    102w    96 54.6     8 2 6 Seizure, right sided hemiparesis Improved  
63 M NSCLC SRS 21 L occipital    15q4w   1.8 100 77     8 0 8 Imbalance, right sided tinnitis Resolved  
Furuse, et al. (2013) [52] 57 F unknown SRS   frontal   5      73.4 40 60 20      Improved  
74 F unknown SRS   frontal   47      74.4 60 60 0      Resolved  
55 M unknown SRS   frontal   49      77.5 80 90 10      Stable  
Yonezawa, et al. (2014) [53] 54 M Lung WBRT
SRS
30
20
  15      55.9 88.9 60 70 10     Seizure, motor weakness Improved  
51 F Lung SRT 30/5 f   23      43.2 65 90 100 10     Headache, numbness Improved  
Sadraei, et al. (2015) [54] 61 M NSCLC SRS 18 Gy R posterofrontal cingulate 8   5q2w 8   35.2 92     24 0.5 23.5 Left sided weakness, gait problems Improved  
46 F NSCLC RT
SRS
36.5
24
R cerebellar 17
11
  5q2w 9   56.1 83.6        Y Improved  
62 M NSCLC SRS 18, 24, 24 Frontal, L temporal 16
4
  7.5q3w 3   + 37.8 + 74.1     16 4 12 Y Improved  
59 F NSCLC WBRT
SRS
44
24
R cerebellar 6
5
     30.8 58.9        Y Resolved Proteinuria (bevacizumab held) grade 1
58 F NSCLC WBRT
SRS
40
24
R temporal L frontoparietal 58
53
  10q2w 9   28.8 34.1     16 0 16 Y Resolved UTI (requiring holding of 1 treatment) grade 2
46 F NSCLC WBRT
SRS
37.5
18
L occipital 17
10
  7.5q3w 10   18.5 48.2     8 0 8 Y Improved  
58 M NSCLC WBRT
SRS
37.5
24
L parietal 11
9
  15q3w 4   100 38.1     8 0 8 Y Improved  
63 F NSCLC SRS 18 Bithalamic L midbrain 18   7.5q3w 4   76.9 52.9     8 0 8 Y No  
55 F Breast WBRT
SRS
37.5
24
L posterofrontal 14
6
  10q2w 5   35.4 43.2     24 2 22 Y Improved  
58 F Breast WBRT
SRS
37.5
18
R frontal 27
11
  5q2w 3   64.7 26.7     8 8 0 Y Improved  
52 F Breast WBRT
SRS
37.5
18
L cerebellar 7
5
  10q2w 13   66.7 32.8     2 1 1 Y Improved  
58 F Melanoma WBRT
SRS
37.5
24
L frontal 3
7
  7.5q3w 2   82.4 74.9     6 4 2 Y Resolved DVT and PE grade 3
39 F Breast WBRT
SRS
37.5
24
L cerebellar 14
8
  10q2w 7   25 77.3     8 0 8 Y Improved fatigue
grade 2
57 F Fallopian tube SRS 20 L parietal 6   15q3w 9   74.5 84.9     8 0 8 Y Resolved  
63 M Rectal WBRT
SRS
37.5
16
L frontal 12
4
  10q2w 8   25.4 13.5     4 2 2 Y Resolved  
67 F NSCLC SRS 18 L frontal 3   10q2w 8   22 53     4 0 4 Y Resolved  
45 M NSTC SRS 18 R frontal 5   5q2w 4   32.2 46.2     4 0 4 Y Resolved Hypertension grade 2
Xiang-Pan, L., et al. (2015) [49] 60 F lung WBRT
SRS
  L temporal 12   7.5q3w            Resolved  
Alessandretti, et al. (2013) [48] 51 F melanoma WBRT
SRS
(3 lesions)
   17   5q2w/
7.5q4w
  3     4 0 4 severe drowsiness, unable to self-ambulate Resolved  
48 F melanoma SRS
WBRT
   6   5q6w        4 0 4 partial seizures (facial tremor) Resolved  
Tanigawa, et al. (2019) [56] 78 M Lung (adenocarcinoma) STI (stereotactic irradiation)    9.2   15q3–4w           Y Resolved Hypertension, proteinuria
74 M Lung (adenocarcinoma) STI (stereotactic irradiation)    12.2   15q3–4w           Y Resolved Hypertension
49 F Lung (adenocarcinoma) STI (stereotactic irradiation)    5   15q3–4w           Y Resolved Oedema, hypertension, proteinuria
44 F Lung (adenocarcinoma) STI (stereotactic irradiation)    4.6   15q3–4w           Y Resolved proteinuria
Ma, Y., et al. (2017) [57] 58 F NSCLC SRS    11   5 mg/kg q2w   4 weeks        speech disorder and weakness in the right arm Improved  
66 F NSCLC SRS    2   7.5 mg/kg q3w           headache and fatigue resolved  
Glitza, I. et al. (2017) [58] 56 M Melanoma WB
SRS
30
18
L frontal 4   7.5 4          Memory loss, seizure Improvement  
71 F Melanoma SRS 20 R frontal 13   7.5 3          Seizures, expressive aphrasia Improvement  
64 F Melanoma WB 30 R parietal 4   7.5 5          Weakness, gait disturbance, aphasia, memory loss Resolution Arthralgia, dysgeusia
52 M Melanoma SRS
WB
20/12/18
30
R frontal 13   5 2           Weakness, gait disturbance, cognitive deficit worsened  
65 M Melanoma SRS 20/16 L temporal 8   7.5 2           None worsened  
37 M Melanoma WB 30 Bifrontal 8   10 6          Behavioral changes, memory loss improvement  
55 M Melanoma SRS 24/21 R occipital/R frontal 7   7.5 4          Seizure, memory loss Improvement  
58 +/−10.6 M 22, F 32      11.7 15.5   5.7 3.29 57.4% 56.2% 56 75 23.75 10.4 1.6 9.08    
  1. Abbreviations: CT Clinical trial, No No of patients, M Male, F Female, WBRT Whole brain radiotherapy, SRS Stereotactic radiosurgery, SRT Stereotactic radiotherapy, EBRT External beam radiotherapy, RT Radiotherapy, FSRT Fractionated stereotactic radiotherapy, RN Radiation necrosis, BV Bevacizumab, Tx Treatment, NSCLC Non-small cell lung cancer, FT Fallopian tube, NSTC Non-seminomatous testicular cancer, MRI Magnetic resonance imaging, PET Positron, emission topography, q2w Every 2 weeks, Y Yes, R Right, L Left