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Changes in protein level in the cerebrospinal fluid of a patient with cerebral radiation necrosis treated with bevacizumab.

Yano H, Nakayama N, Morimitsu K, Futamura M, Ohe N, Miwa K, Shinoda J, Iwama T - Clin Med Insights Oncol (2014)

Bottom Line: Interestingly, after 2 days, the agents had dramatically reduced the CSF protein level.After 10 courses of this regimen, the CSF protein level decreased to 338 mg/dL, which is less than half of the initial level.Long-term administration of bevacizumab might decrease leakage of protein from the vessels around the ventriculus.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.

ABSTRACT
A 32-year-old woman underwent surgeries and radiation therapy for astrocytoma. She developed symptomatic radiation necrosis in the lesion, which caused hydrocephalus. She initially underwent ventricular drainage, because the protein level in the cerebrospinal fluid (CSF) was 787 mg/dL, which was too high for shunt surgery. Because she also had breast cancer, which was pathologically diagnosed as an invasive ductal carcinoma, standard bevacizumab therapy in combination with paclitaxel every 2 weeks was selected. Interestingly, after 2 days, the agents had dramatically reduced the CSF protein level. However, it returned to approximately the initial level within 2 weeks. After two courses of this regimen, a ventriculoperitoneal shunt was placed. After 10 courses of this regimen, the CSF protein level decreased to 338 mg/dL, which is less than half of the initial level. Long-term administration of bevacizumab might decrease leakage of protein from the vessels around the ventriculus.

No MeSH data available.


Related in: MedlinePlus

(A) Tomotherapy planning and findings confirming radiation necrosis. The yellow circle indicates the 56 Gy dosage. (B) An axial fluid attenuated inversion recovery image showing the left frontal lesion with broad brain edema extending to the contralateral hemisphere. (C) A methionine positron emission tomography scan showing only a small uptake of methionine. (D) A photomicrograph of the hematoxylin and eosin-stained section of the specimen obtained at the third surgery shows radiation necrosis.
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f2-cmo-8-2014-153: (A) Tomotherapy planning and findings confirming radiation necrosis. The yellow circle indicates the 56 Gy dosage. (B) An axial fluid attenuated inversion recovery image showing the left frontal lesion with broad brain edema extending to the contralateral hemisphere. (C) A methionine positron emission tomography scan showing only a small uptake of methionine. (D) A photomicrograph of the hematoxylin and eosin-stained section of the specimen obtained at the third surgery shows radiation necrosis.

Mentions: Postoperatively, she received intensity-modulated radiation therapy using tomotherapy with temozolomide at a marginal dose of 56 Gy (Fig. 2A). Eighteen months after the radiation therapy, her daily activities gradually deteriorated. Enhanced MRI revealed a small lesion with extensive edema in the left frontal lobe (Fig. 2B). The positron emission tomography (PET) scan showed no uptake of fluorodeoxyglucose and low uptake of methionine (Fig. 2C). She underwent a third surgery to remove the lesion, which was pathologically confirmed as RN (Fig. 2D).


Changes in protein level in the cerebrospinal fluid of a patient with cerebral radiation necrosis treated with bevacizumab.

Yano H, Nakayama N, Morimitsu K, Futamura M, Ohe N, Miwa K, Shinoda J, Iwama T - Clin Med Insights Oncol (2014)

(A) Tomotherapy planning and findings confirming radiation necrosis. The yellow circle indicates the 56 Gy dosage. (B) An axial fluid attenuated inversion recovery image showing the left frontal lesion with broad brain edema extending to the contralateral hemisphere. (C) A methionine positron emission tomography scan showing only a small uptake of methionine. (D) A photomicrograph of the hematoxylin and eosin-stained section of the specimen obtained at the third surgery shows radiation necrosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4263439&req=5

f2-cmo-8-2014-153: (A) Tomotherapy planning and findings confirming radiation necrosis. The yellow circle indicates the 56 Gy dosage. (B) An axial fluid attenuated inversion recovery image showing the left frontal lesion with broad brain edema extending to the contralateral hemisphere. (C) A methionine positron emission tomography scan showing only a small uptake of methionine. (D) A photomicrograph of the hematoxylin and eosin-stained section of the specimen obtained at the third surgery shows radiation necrosis.
Mentions: Postoperatively, she received intensity-modulated radiation therapy using tomotherapy with temozolomide at a marginal dose of 56 Gy (Fig. 2A). Eighteen months after the radiation therapy, her daily activities gradually deteriorated. Enhanced MRI revealed a small lesion with extensive edema in the left frontal lobe (Fig. 2B). The positron emission tomography (PET) scan showed no uptake of fluorodeoxyglucose and low uptake of methionine (Fig. 2C). She underwent a third surgery to remove the lesion, which was pathologically confirmed as RN (Fig. 2D).

Bottom Line: Interestingly, after 2 days, the agents had dramatically reduced the CSF protein level.After 10 courses of this regimen, the CSF protein level decreased to 338 mg/dL, which is less than half of the initial level.Long-term administration of bevacizumab might decrease leakage of protein from the vessels around the ventriculus.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Gifu University Graduate School of Medicine, Gifu, Japan.

ABSTRACT
A 32-year-old woman underwent surgeries and radiation therapy for astrocytoma. She developed symptomatic radiation necrosis in the lesion, which caused hydrocephalus. She initially underwent ventricular drainage, because the protein level in the cerebrospinal fluid (CSF) was 787 mg/dL, which was too high for shunt surgery. Because she also had breast cancer, which was pathologically diagnosed as an invasive ductal carcinoma, standard bevacizumab therapy in combination with paclitaxel every 2 weeks was selected. Interestingly, after 2 days, the agents had dramatically reduced the CSF protein level. However, it returned to approximately the initial level within 2 weeks. After two courses of this regimen, a ventriculoperitoneal shunt was placed. After 10 courses of this regimen, the CSF protein level decreased to 338 mg/dL, which is less than half of the initial level. Long-term administration of bevacizumab might decrease leakage of protein from the vessels around the ventriculus.

No MeSH data available.


Related in: MedlinePlus