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Bevacizumab for Hearing Preservation in Neurofibromatosis Type 2: Emphasis on Patient-Reported Outcomes and Toxicities.
Sverak, Pavlina; Adams, Meredith E; Haines, Stephen J; Levine, Samuel C; Nascene, David; Sommer, Katherine; Dusenbery, Kathryn; Huang, Tina C; Moertel, Christopher.
Afiliación
  • Sverak P; 1 Department of Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, Minnesota, USA.
  • Adams ME; 2 Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
  • Haines SJ; 3 Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA.
  • Levine SC; 2 Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
  • Nascene D; 3 Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA.
  • Sommer K; 4 Department of Radiology, University of Minnesota, Minneapolis, Minnesota, USA.
  • Dusenbery K; 1 Department of Pediatric Hematology/Oncology, University of Minnesota, Minneapolis, Minnesota, USA.
  • Huang TC; 5 Department of Radiation Oncology, University of Minnesota, Minneapolis, Minnesota, USA.
  • Moertel C; 2 Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Otolaryngol Head Neck Surg ; 160(3): 526-532, 2019 03.
Article en En | MEDLINE | ID: mdl-30373466
OBJECTIVE: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Seventeen consecutive patients with NF2 received bevacizumab treatment for vestibular schwannomas, including 2 patients treated to maintain cochlear implant performance. Volumetric analysis of serial magnetic resonance imaging scans was used to evaluate radiographic response, and hearing response was evaluated with serial audiograms. Patient-reported outcomes were also assessed, including subjective hearing improvement, changes in tinnitus, vertigo, headaches, ear pain, and improvement in ability to communicate via telephone. RESULTS: A positive radiographic response occurred in 8 of 17 (47%) patients and the median tumor volume change was a tumor decrease of 19%. A positive hearing response was recorded in 5 of 9 (56%) patients. Two patients had a word recognition score improvement over 40%. There was an approximately 40% improvement in patient-reported outcomes. Primary toxicities included hypertension, proteinuria, dysgeusia, and amenorrhea. CONCLUSION: Bevacizumab treatment was followed by hearing improvement in 56% of patients, while decreased tumor volume was noted in 47%. These outcomes agree favorably with prior reported series. There were significant improvements in patient-reported outcomes that have not been described previously.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuroma Acústico / Neurofibromatosis 2 / Inhibidores de la Angiogénesis / Bevacizumab / Pérdida Auditiva Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuroma Acústico / Neurofibromatosis 2 / Inhibidores de la Angiogénesis / Bevacizumab / Pérdida Auditiva Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Otolaryngol Head Neck Surg Asunto de la revista: OTORRINOLARINGOLOGIA Año: 2019 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido