Comparing Bevacizumab and Dexamethasone as First Treatment for Symptomatic Cerebral Radiation Necrosis in Adults with High-grade Glioma or Brain Metastases

What this Trial Is About

This trial investigates cerebral radiation necrosis CRN, a serious complication following high-dose radiation treatment for brain metastases or high-grade glioma. It aims to compare the effectiveness of two first-line treatments, bevacizumab and dexamethasone, in managing symptomatic CRN. The study focuses on improving patient well-being and quality of life while minimizing corticosteroid use to support ongoing cancer treatments. Participants are randomly assigned to receive either intravenous bevacizumab at a fixed dose of 600 mg every three weeks for four doses over 12 weeks or daily oral dexamethasone with a tapering dose protocol for 12 weeks. Bevacizumab patients may also use dexamethasone concurrently if needed. After treatment, patients are followed for two years to monitor outcomes. During the study, participants will have regular hospital visits and brain MRI scans. They will complete cognitive tests, quality of life, epilepsy, productivity, and medical cost questionnaires during treatment and follow-up. Optional blood samples may be collected for research. Researchers will assess clinical efficacy, quality of life, cognitive function, treatment toxicity, seizure control, tumor progression, survival, and cost-effectiveness over the course of treatment and follow-up.

Bevacizumab Versus Corticosteroids as First-line Treatment in Patients With Symptomatic Cerebral Radiation Necrosis After Radiation for High-grade Glioma or Brain Metastases