Bevacizumab for the Management of Pediatric Radiation Necrosis: a Narrative Review

Radiation necrosis (RN) presents a significant challenge in the treatment of pediatric central nervous system tumors. This narrative review synthesizes current evidence on the use of bevacizumab (BEV) for managing pediatric RN, drawing from case reports, retrospective reviews, and prospective clinical trials. While high-quality prospective data remain limited, emerging evidence suggests that BEV may be effective in alleviating both clinical symptoms and radiographic manifestations of RN in pediatric patients. This review explores the pathophysiology of RN, BEV’s mechanism of action, and existing evidence on the use of BEV in pediatric RN. Emerging evidence suggests that bevacizumab may provide symptomatic relief and radiographic improvement in pediatric patients with RN. By addressing current knowledge gaps, the aim is to provide insight into the potential role of BEV in improving outcomes for pediatric patients with RN.