To compare the characteristics, risk factors and stroke types in patients who suffered strokes after radiation therapy for primary brain gliomas based on bevacizumab (Avastin) use at the time of their stroke.  

Treatment of high-grade brain gliomas most commonly involves chemotherapeutics in combination with radiation therapy. Cranial radiation and bevacizumab are associated with an increased risk of cerebral ischemia and intraparenchymal hemorrhage (IPH). It is not clear if the types and risks for stroke differ between those taking Bevacizumab vs. not. 

This is a retrospective cohort from a single tertiary academic brain tumor center of patients with primary gliomas who also received radiation therapy and had a subsequent stroke. We compared the characteristics of patients with stroke on bevacizumab to those not on bevacizumab at the time of stroke. 

Among the 93 patients with primary gliomas who received radiation therapy and who were diagnosed with subsequent stroke [45.0% women, mean age 53.3 (SD 15.09)], 64.5% (N=60) were also taking bevacizumab. Compared to those who were not taking bevacizumab at the time of stroke, those who were taking bevacizumab were more commonly diagnosed with IPH (31.7% vs. 15.1%, OR 2.60, 95% CI 0.87-7.77, P=0.09) as compared to ischemic stroke or subarachnoid hemorrhage. However, 36.8% of patients taking Bevacizumab were also taking anticoagulant medications as compared to none in the group not taking Bevacizumab. Baseline demographics, radiation dosing, and cerebrovascular risk factors were similar between the two groups.

Patients with primary brain tumors undergoing radiation therapy who were diagnosed with a stroke while on bevacizumab have similar risk factors and demographics as compared to those not on bevacizumab. Patients on bevacizumab at the time of their stroke more commonly suffered IPH, though more of these patients were exposed to concomitant anticoagulation.