He WM, Li WS. Investigating radiotherapy’s impact on intestinal perforation risk in gastrointestinal tumor patients treated with bevacizumab. World J Gastrointest Oncol 2025; 17(12): 110621 [DOI: 10.4251/wjgo.v17.i12.110621]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 15, 2025 (publication date) through Dec 17, 2025
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World Journal of Gastrointestinal Oncology
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1948-5204
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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He WM, Li WS. Investigating radiotherapy’s impact on intestinal perforation risk in gastrointestinal tumor patients treated with bevacizumab. World J Gastrointest Oncol 2025; 17(12): 110621 [DOI: 10.4251/wjgo.v17.i12.110621]
World J Gastrointest Oncol. Dec 15, 2025; 17(12): 110621 Published online Dec 15, 2025. doi: 10.4251/wjgo.v17.i12.110621
Investigating radiotherapy’s impact on intestinal perforation risk in gastrointestinal tumor patients treated with bevacizumab
Wei-Mei He, Wen-Si Li
Wei-Mei He, Department of Pharmaceutical, Affiliated Hospital of Youjiang University of Ethnic Medicine, Baise 533000, Guangxi Zhuang Autonomous Region, China
Wen-Si Li, Department of Infirmary, Guilin Tourism University, Guilin 541006, Guangxi Zhuang Autonomous Region, China
Author contributions: He WM designed the research study; Li WS performed the research; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: The research was reviewed and approved by Affiliated Hospital of Youjiang University of Ethnic Medicine, approval No. YYFY-LL-2023-60.
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No other data available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: July 1, 2025 Revised: August 7, 2025 Accepted: October 15, 2025 Published online: December 15, 2025 Processing time: 163 Days and 0.2 Hours
Abstract
BACKGROUND
Gastrointestinal tumors are among the most common and deadly cancers globally, with radiotherapy and bevacizumab being key treatment strategies. Radiotherapy uses high-energy radiation to target DNA, reducing tumor size and alleviating symptoms. Bevacizumab, a targeted therapy, inhibits angiogenesis and tumor growth, particularly in advanced gastrointestinal cancers. However, both treatments can cause adverse gastrointestinal effects, such as intestinal mucosal damage and perforation. While research on the risk of intestinal perforation has grown, the underlying mechanisms remain underexplored. This study aims to compare the incidence of intestinal perforation and survival rates in patients treated with radiotherapy combined with bevacizumab vs bevacizumab alone.
AIM
To investigate the effect of radiotherapy on the risk of intestinal perforation in patients with colon cancer treated with bevacizumab.
METHODS
A total of 70 patients diagnosed with gastrointestinal malignancies admitted to our hospital from January 2023 to December 2024 were selected as research subjects. According to different treatment methods, 70 patients were divided into the bevacizumab only group (receiving bevacizumab treatment) and the bevacizumab + radiotherapy group (receiving radiotherapy combined with bevacizumab treatment), with 35 cases in each group. The two groups were compared in terms of clinical efficacy, incidence of intestinal perforation, serum tumor marker levels, overall survival and progression-free survival, levels of angiogenic factors, and adverse reactions.
RESULTS
Compared with the group treated with bevacizumab alone, the group treated with bevacizumab plus radiotherapy showed significant improvements in effective rate, overall survival, and progression-free survival (P < 0.05); the probability of intestinal perforation in the bevacizumab + radiotherapy group was 13.33%, while the probability of intestinal perforation in the bevacizumab group was 0. There was a statistically significant difference in the incidence of intestinal perforation between the two groups (P = 0.039). Following treatment, the levels of carbohydrate antigen (CA) 125, CA199, and CA153 in patients were significantly reduced (P < 0.05).
CONCLUSION
Radiation therapy may increase the risk of intestinal perforation in colon cancer patients receiving bevacizumab treatment. In clinical applications, the risks of combined use of radiotherapy and bevacizumab should be fully considered and personalized treatment plans should be formulated.
Core Tip: This study investigates the risk of intestinal perforation in gastrointestinal tumor patients treated with radiotherapy combined with bevacizumab vs bevacizumab alone. While radiotherapy and bevacizumab are essential for managing advanced gastrointestinal cancers, both treatments can cause gastrointestinal complications, including perforation. The study compares the incidence of intestinal perforation and survival outcomes, aiming to inform clinical decision-making and enhance patient safety.
