Brain radiation necrosis treated with bevacizumab in a patient with advanced squamous cell lung carcinoma: A case report

Brain radiation necrosis is a serious adverse effect of radiotherapy in patients with malignant brain metastases. There is currently no standard treatment for brain radiation necrosis; however, there are advantages to using bevacizumab. Nonetheless, due to the risk of severe bleeding when bevacizumab is used in patients with squamous cell lung carcinoma, relevant clinical studies are lacking; therefore, there is no clear conclusion on the use of bevacizumab to treat brain radiation necrosis in patients with squamous cell carcinoma of the lung with brain metastases. The present study described the case of a patient treated with bevacizumab after brain radiation injury with pathological manifestations diagnosed as squamous cell carcinoma of the lung. Through the evaluation of clinical symptoms and imaging data, the patient was diagnosed with cerebral radiation necrosis a few months after receiving local radiotherapy for intracranial metastatic lesions. After four cycles of treatment with bevacizumab (7.5 mg/kg once every 3 weeks, intravenous drip), the clinical and imaging manifestations of the patient were considerably improved with no significant adverse effects. The favorable efficacy and safety profiles of this patient suggest that bevacizumab holds potential as a future therapeutic option for managing radiation-induced brain necrosis in patients with squamous cell lung cancer.