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ORIGINAL RESEARCH article

Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 15 - 2024 | doi: 10.3389/fimmu.2024.1399613
This article is part of the Research Topic Treatment of Brain Metastases from Non-Small Cell Lung Cancer: Preclinical, Clinical, and Translational Research View all 10 articles

Bevacizumab reduces cerebral radiation necrosis due to stereotactic radiotherapy in non-small cell lung cancer patients with brain metastases: An inverse probability of treatment weighting analysis

Provisionally accepted
Jingwei Zhang Jingwei Zhang 1Jiayi Yu Jiayi Yu 2Dan Yang Dan Yang 2Leilei Jiang Leilei Jiang 2Xin Dong Xin Dong 2Zhi Yan Liu Zhi Yan Liu 2Rong Yu Rong Yu 2Huiming Yu Huiming Yu 2Anhui Shi Anhui Shi 2*
  • 1 Capital Medical University, Beijing, Beijing Municipality, China
  • 2 Key Laboratory of Carcinogenesis and Translational Research, Beijing Cancer Hospital, Peking University, Beijing, Beijing Municipality, China

The final, formatted version of the article will be published soon.

    Background: Cerebral radiation necrosis (RN), a severe complication of stereotactic radiotherapy (SRT), has been shown to significantly decrease patient survival time and quality of life. The purpose of this study was to analyze whether bevacizumab can prevent or reduce the occurrence of SRTinduced cerebral RN in non-small cell lung cancer (NSCLC) patients with brain metastases. Materials and Methods: We retrospectively reviewed the clinical records of NSCLC patients with brain metastases from March 2013 to June 2023 who were treated with SRT. Patients were divided into two groups: those in the bevacizumab group received SRT with four cycles of bevacizumab, and patients in the control group received SRT only. Inverse probability of treatment weighting (IPTW) was performed based on a multinomial propensity score model to balance the baseline characteristics. The chi-square test was used. A Cox model was used to evaluate overall survival (OS). Results: A total of 80 patients were enrolled, namely, 28 patients in the bevacizumab group and 52 patients in the control group. The possibility of developing cerebral RN and/or symptomatic edema (RN/SE) was significantly decreased in patients treated with bevacizumab compared to those who did not receive bevacizumab before IPTW (p=0.036) and after IPTW (p=0.015) according to chisquare analysis. The IPTW-adjusted median OS was 47.7 months (95% CI 27.4-80.8) for patients in the bevacizumab group and 44.1 months (95% CI 36.7-68.0) (p=0.364) for patients in the control group.The application of bevacizumab concurrent with SRT may prevent or reduce the occurrence of cerebral RN in NSCLC patients with brain metastases.

    Keywords: bevacizumab, Radiation, radionecrosis, stereotactic, NSCLC, brain metastases

    Received: 12 Mar 2024; Accepted: 07 Aug 2024.

    Copyright: © 2024 Zhang, Yu, Yang, Jiang, Dong, Liu, Yu, Yu and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anhui Shi, Key Laboratory of Carcinogenesis and Translational Research, Beijing Cancer Hospital, Peking University, Beijing, 100142, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.