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First published on August 29, 2008
This version was published on January 1, 2009
Neuro Oncol 2009 11(1):92-95; DOI:10.1215/15228517-2008-071
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Case Study

Colon perforation during antiangiogenic therapy for malignant glioma

Andrew D. Norden, Jan Drappatz, Abigail Slate Ciampa, Lisa Doherty, Debra Conrad LaFrankie, Santosh Kesari and Patrick Y. Wen

Division of Neuro-Oncology, Department of Neurology, Brigham and Women's Hospital, Boston, MA (A.D.N., J.D., S.K., P.Y.W.); Center for Neuro-Oncology, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (A.D.N., J.D., A.S.C., L.D., D.C.L., S.K., P.Y.W.); Harvard Medical School, Boston, MA, (A.D.N., J.D., S.K., P.Y.W.); USA

Address correspondence to Andrew D. Norden, Center for Neuro-Oncology, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115, USA (anorden{at}partners.org).

Antiangiogenic drugs have emerged as effective treatment options for patients with recurrent malignant gliomas (MGs). Though this class of drugs is generally well tolerated, rare life-threatening complications, including thromboembolism, hemorrhage, and gastrointestinal (GI) perforation, are reported. We describe six cases of GI perforation among 244 glioma patients (2.5%) during treatment with antiangiogenic agents in combination with chemotherapy and corticosteroids. Two patients succumbed to this complication, and the others recovered. Because GI perforation is a life-threatening yet treatable complication, neurooncologists must have a low threshold to consider it in patients on antiangiogenic drug therapy who present with abdominal pain and other GI complaints.

Key Words: antiangiogenic drugs • bevacizumab • gastrointestinal perforation • malignant glioma


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