Bevacizumab combined with head Gamma knife radiosurgery for brain metastases:analysis of shortterm efficacy and prognostic factors
Zong Jianhai
Liu Huafeng
Xue Yafei
Cheng Yun
Wang JiLin
Ji Na
Hou Xiangkun
Xi Aohang
He Shiming
Abstract：Objective To evaluate the shortterm efficacy of bevacizumab combined with head Gamma Knife stereotactic radio-surgery for brain metastases and to analyze factors influencing prognosis,thereby providing new evidencebased insights into comprehensive treatment strategies.Methods Clinical data and oneyear followup information from 108 patients with brain me-tastases treated at Xi'an International Medical Center Hospital between January 2020 and January 2023 were retrospectively an-alyzed.Patients were assigned equally into a control group(n=54),which received GKRS alone,and an observation group(n=54),which received intravenous bevacizumab plus GKRS.Shortterm therapeutic efficacy and adverse events during treat-ment were compared between the groups.Multivariate Cox regression analysis was used to identify prognostic influencing fac-tors.Results The overall response rate in the observation group was significantly higher than that in the control group[79.63%(43/54)vs.51.85%(28/54);χ2=9.250,P=0.002].Adverse event rates during treatment were 98.15%(53/54)in the observation group and 88.89%(48/54)in the control group,with no statistically significant difference(χ2=2.444,P=0.118).The oneyear postdischarge survival rate for all 108 patients was 86.11%(93/108).The survival rate dif-fered significantly at one year according to primary tumor type,total intracranial metastatic volume,maximum metastatic di-ameter of brain,and treatment regimen(P<0.05).Multivariate Cox regression identified total metastatic volume>20 cm3(HR=3.391,95%CI:1.836-6.262),maximum metastatic diameter of brain>3 cm(HR=2.625,95%CI:1.372-5.022),and treatment with radiotherapy alone(HR=3.294,95%CI:1.780-6.095)as risk factors for poorer prognosis a-mong these patients(P<0.05).Conclusion Bevacizumab combined with head Gamma Knife radiosurgery significantly promotes shortterm efficacy in patients with brain metastases,with manageable safety.For patients with total metastatic volume>20 cm3 or maximum diameter>3 cm,this combined regimen should be preferentially recommended to mitigate the risk of unfavorable outcomes.
Keywords：Brain metastasesBevacizumabHead Gamma knifeShortterm efficacyPrognosisRisk factors
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 76-81 )