Abstract
BACKGROUND: Bevacizumab (BVZ) is widely used in patients with central nervous system (CNS) tumors. Due to its potential to impair wound healing, a minimum interval of 28 days between BVZ administration and surgery - both before and after the procedure - is generally recommended. However, strict adherence to this interval is often challenging in clinical practice, particularly when urgent oncologic treatment or time-sensitive surgical interventions are required. METHODS: Pediatric patients with a CNS tumor receiving intravenous BVZ from January 2005 to December 2022 treated at the Medical University of Vienna were retrospectively analyzed for surgical complications. RESULTS: One hundred and nineteen patients had 344 surgeries with BVZ therapy before and or after surgery. 11 wound complications (3.20%) of any grade (n=1 CTCAE grade I; n=10 CTCAE grade III) occurred in 11 children (9.24%). Group comparison of BVZ exposure intervals (BVZ ≤28/>28 days and ≤14/>14 days) revealed no statistically significant differences in wound complication rates, with odds ratios of 3.91 (≤28/>28 d; P = .55) and 1.15 (≤14/>14 d; P=1.00) before surgery as well as 1.93 (≤28/>28 d; P = .46) and 3.16 (≤14/>14 d; P = .11) after surgery. CONCLUSION: BVZ can be administered within ≤ 28 days before or after surgery when postponing the procedure is not feasible or when immediate (re)initiation of therapy is required, provided that non-absorbable sutures are used, and close wound-monitoring is ensured.