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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