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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

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Bevacizumab reduces toxicity of reirradiation in recurrent high-grade glioma

Bevacizumab reduziert die Toxizität einer Rebestrahlung des rezidivierenden malignen Glioms

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  • presenting/speaker Niklas Thon - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland
  • Daniel Fleischmann - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Strahlentherapie, München, Deutschland
  • Joerg-Christian Tonn - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland
  • Friedrich-Wilhelm Kreth - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Neurochirurgie, München, Deutschland
  • Claus Belka - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Strahlentherapie, München, Deutschland
  • Karim-Maximilian Niyazi - Klinikum der Ludwig-Maximilians-Universität – Campus Großhadern, Strahlentherapie, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV126

doi: 10.3205/19dgnc141, urn:nbn:de:0183-19dgnc1411

Published: May 8, 2019

© 2019 Thon et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Reirradiation (reRT) with concomitant bevacizumab (BEV) is an attractive salvage treatment concept for selected patients with malignant glioma recurrence after multimodal treatment. Due to a decision of the European Medical Agency based on negative first line results, however, BEV was disapproved for glioma treatment in Europe. Following this decision, we stopped to apply BEV in this setting. Here we report on our experience on reRT with and without concomitant BEV.

Methods: Patients from our institutional database were included, if they had undergone reRT for recurrent high-grade glioma. Descriptive statistics were used to assess patient characteristics among the patients treated with and without concomitant BEV therapy to reRT. Multivariate logistic regression analysis was performed to assess risk factors for neurologic toxicity.

Results: Overall, 161 patients were included into this retrospective analysis. 124 received BEV and 37 no BEV concomitant to reRT. Radiation necrosis and/or symptomatic edema (RNSE) was diagnosed in 27/124 patients (21.8%) treated with reRT with concomitant BEV and in 14/37 patients (37.8%) treated with reRT only (p=0.025). Radiation necrosis (RN) was diagnosed in 6/124 (4.8%) and 5/37 patients, respectively (13.5%; p=0.078). Concomitant BEV therapy was significantly related to RNSE-free survival (p=0.005) and to RN-free survival (p=0.025) on log-rank test.

Conclusion: Concomitant BEV treatment to reRT is strongly advised for patients with recurrent high-grade glioma as it is related to lower neurologic toxicity.