Current state of antiangiogenic therapy in neuro-oncology and own experience of its use in the radiosurgical treatment of recurrent glioblastoma

Authors

  • Oleksandr Y. Glavatskyi Romodanov Neurosurgery Institute, Kyiv, Ukraine
  • Oksana V. Zemskova Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0001-9462-8330
  • Hennadii V. Khmelnytskyi Romodanov Neurosurgery Institute, Kyiv, Ukraine
  • Konstantin A. Kardash Odesa National Medical University, Odesa, Ukraine https://orcid.org/0000-0002-5208-2736
  • Iryna M. Shuba Romodanov Neurosurgery Institute, Kyiv, Ukraine
  • Valentyna V. Lylo Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, Kyiv, Ukraine
  • Olga Y. Chuvashova Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0001-6767-4665
  • Andrey B. Gryazov Romodanov Neurosurgery Institute, Kyiv, Ukraine https://orcid.org/0000-0003-1785-6705
  • Volodymyr A. Stuley Institute for Applied Systems Analysis (IASA), National Technical University of Ukraine “Igor Sikorsky Kyiv Polytechnic Institute”, Kyiv, Ukraine https://orcid.org/0000-0001-7552-7024
  • Tetiana M. Kozarenkо Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

DOI:

https://doi.org/10.25305/unj.223479

Keywords:

glioblastoma, angiogenesis, anti-angiogenic therapy, bevacizumab, stereotactic radiosurgery, quality of life, headache

Abstract

Objective: to study the effect of antiangiogenic therapy on the quality of life and the level of headache in patients with recurrent glioblastoma who underwent radiosurgical treatment.

Materials and methods. A prospective randomized single-center study carried out at the Romodanov Neurosurgery Institute of National Academy of Medical Sciences of Ukraine in 2019-2020 involving 45 patients with GB with clinical and radiological signs of disease progression and local tumor recurrence. In this regard, patients underwent radiosurgical treatment. In the main group (BEV+) 21 patients after stereotactic radiosurgery (SRS) underwent antiangiogenic therapy with Bevacizumab (BEV). In the control group (BEV), 24 patients did not receive antiangiogenic therapy after SRS.

SRS with the use of a linear accelerator «Trilogy» (6 MeV) using intensity-modulated radiotherapy (IMRT). BEV was administered intravenously, once every 3 weeks at a dose of 10 mg / kg body weight. Antiangiogenic therapy was performed under the condition of preserved liver and kidney function, values of full blood count and blood biochemistry within normal range.

Global health status and headache levels were calculated according to EORTC QLQ-C30 v. 3.0 and QLQ-BN20 before and six weeks after radiosurgery in the main and control groups.

Results. There was no a statistically significant difference between the studied groups of patients’ in quality of life (p = 0.707372) and in headache level (p = 0.846660) before the SRS.

Six weeks after SRS, patients in the main group had a statistically significantly higher quality of life (p = 0.000015) and a lower level of headache than patients in the control group (p = 0.000035).

During the observation period in patients of both groups there were no adverse events of III-IV degree of toxicity, in particular specific complications of antiangiogenic therapy (hypertension, bleeding, thromboembolism, leukopenia, proteinuria, gastrointestinal disorders, etc.).

Conclusions. Antiangiogenic therapy statistically significantly improves the quality of life and reduces the level of headache in patients who underwent radiosurgical treatment for glioblastoma recurrence.

Author Biographies

Oksana V. Zemskova , Romodanov Neurosurgery Institute, Kyiv, Ukraine

Department of Adjuvant Treatment for CNS Tumors; Department of Radioneurosurgery

Hennadii V. Khmelnytskyi, Romodanov Neurosurgery Institute, Kyiv, Ukraine

Department of Adjuvant Treatment for CNS Tumors

Konstantin A. Kardash, Odesa National Medical University, Odesa, Ukraine

Department of Neurology and Neurosurgery

Iryna M. Shuba, Romodanov Neurosurgery Institute, Kyiv, Ukraine

Department of Neurobiochemistry

Valentyna V. Lylo, Institute of Molecular Biology and Genetics of National Academy of Sciences of Ukraine, Kyiv, Ukraine

Department of Protein Engineering and Bioinformatics

Olga Y. Chuvashova, Romodanov Neurosurgery Institute, Kyiv, Ukraine

Department of Neuroradiology and Radioneurosurgery

Andrey B. Gryazov, Romodanov Neurosurgery Institute, Kyiv, Ukraine

Department of Radioneurosurgery

Volodymyr A. Stuley, Institute for Applied Systems Analysis (IASA), National Technical University of Ukraine “Igor Sikorsky Kyiv Polytechnic Institute”, Kyiv, Ukraine

Department of Mathematical Methods of Systems Analysis

Tetiana M. Kozarenkо, Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine

Radiology Department

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Published

2021-03-29

How to Cite

Glavatskyi, O. Y., Zemskova , O. V., Khmelnytskyi, H. V., Kardash, K. A., Shuba, I. M. ., Lylo, V. V., Chuvashova, O. Y., Gryazov, A. B., Stuley, V. A., & Kozarenkо T. M. (2021). Current state of antiangiogenic therapy in neuro-oncology and own experience of its use in the radiosurgical treatment of recurrent glioblastoma. Ukrainian Neurosurgical Journal, 27(1), 34–43. https://doi.org/10.25305/unj.223479

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Section

Original articles