Author Affiliations: Departments of Neurology and Neurological Surgery (Dr Chamberlain), Medicine(Dr Eaton), and Radiology (Dr Fink), University of Washington, Seattle.
A 54-year-old man with previously treated (chemoradiation and surgery without concurrent corticosteroids) squamous cell carcinoma of the right tonsil developed a paraparesis and thoracic truncal sensory disturbance at T3 after completing 15 months of cisplatin-based chemoradiotherapy (estimated spinal cord dose, 4800 cGy [to convert centigray to rad, multiply by 100]). The clinical and radiographic findings (Figure, A and B) were consistent with delayed late radiation myelitis. Treatment was initiated with 4 cycles of bevacizumab (5 mg/kg once every 2 weeks), resulting in clinical stabilization and apparent regression by radiography (Figure, C and D). Following treatment with bevacizumab only, the patient was able to resume playing golf and ambulated without an assistive device.
Chamberlain MC, Eaton KD, Fink J. Radiation-Induced MyelopathyTreatment With Bevacizumab. Arch Neurol. 2011;68(12):1608–1609. doi:10.1001/archneurol.2011.621