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Title: Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part II: Differences in obliteration rates, treatment-obliteration intervals, and prognostic factors

Abstract

Purpose: To evaluate and compare obliteration rates (OBRs) and treatment-obliteration intervals (TOIs) for cerebral arteriovenous malformations (cAVMs) treated with Gamma Knife radiosurgery in children/adolescents and adults; and to determine factors predicting the OBR and TOI in these two populations. Methods and Materials: This study concerned 62 children/adolescents and 193 adults observed for {>=}3 years. Fisher exact two-tailed and Wilcoxon rank-sum tests, multiple logistics, and Cox proportional hazard models were used for statistical analysis. Results: The overall OBR was 85.5% in children/adolescents and 87.6% in adults (p 0.671), but children/adolescents showed higher 36-month actuarial OBRs (69.35%) and shorter median TOIs (25.7 months) than adults (66.84% and 28.2 months; p 0.006 and p = 0.017, respectively). In children/adolescents, lower Spetzler-Martin grades (p = 0.043) and younger age (p = 0.019) correlated significantly with OBRs, and lower Spetzler-Martin grades (p 0.024) and noneloquent cAVM locations (p = 0.046) with TOIs. In adults, low flow through the cAVM and <6.2-cm{sup 3} volume were associated with both OBR and TOI (p 0.012 and p = 0.002, respectively). Conclusions: The differences in OBRs within 3 years and TOIs, although slight, seem to show that pediatric cAVMs behave differently from those in adults after Gamma Knife radiosurgery.

Authors:
 [1];  [2];  [3];  [4];  [2];  [3];  [2];  [3];  [2];  [3];  [2];  [3];  [2];  [3];  [2];  [3]
  1. Department of Neurosurgery, University of Verona and University Hospital, Verona (Italy) and Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona (Italy). E-mail: antonio.nicolato@mail.azosp.vr.it
  2. Department of Neurosurgery, University of Verona and University Hospital, Verona (Italy)
  3. (Italy)
  4. Interdepartmental Centre of Economic Documentation, University of Verona and University Hospital, Verona (Italy)
Publication Date:
OSTI Identifier:
20793364
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 64; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2005.09.013; PII: S0360-3016(05)02604-0; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ADOLESCENTS; CHILDREN; HAZARDS; MALFORMATIONS; RADIOTHERAPY; SURGERY

Citation Formats

Nicolato, Antonio, Lupidi, Francesco, Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Sandri, Marco F. Dr. Econom., Foroni, Roberto, Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Zampieri, Piergiuseppe, Section of Neuroradiology, University of Verona and University Hospital, Verona, Mazza, Carlo, Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona, Pasqualin, Alberto, Neurosurgical Clinic, University of Verona and University Hospital, Verona, Beltramello, Alberto, Section of Neuroradiology, University of Verona and University Hospital, Verona, Gerosa, Massimo, and Neurosurgical Clinic, University of Verona and University Hospital, Verona. Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part II: Differences in obliteration rates, treatment-obliteration intervals, and prognostic factors. United States: N. p., 2006. Web. doi:10.1016/J.IJROBP.2005.0.
Nicolato, Antonio, Lupidi, Francesco, Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Sandri, Marco F. Dr. Econom., Foroni, Roberto, Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Zampieri, Piergiuseppe, Section of Neuroradiology, University of Verona and University Hospital, Verona, Mazza, Carlo, Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona, Pasqualin, Alberto, Neurosurgical Clinic, University of Verona and University Hospital, Verona, Beltramello, Alberto, Section of Neuroradiology, University of Verona and University Hospital, Verona, Gerosa, Massimo, & Neurosurgical Clinic, University of Verona and University Hospital, Verona. Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part II: Differences in obliteration rates, treatment-obliteration intervals, and prognostic factors. United States. doi:10.1016/J.IJROBP.2005.0.
Nicolato, Antonio, Lupidi, Francesco, Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Sandri, Marco F. Dr. Econom., Foroni, Roberto, Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona, Zampieri, Piergiuseppe, Section of Neuroradiology, University of Verona and University Hospital, Verona, Mazza, Carlo, Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona, Pasqualin, Alberto, Neurosurgical Clinic, University of Verona and University Hospital, Verona, Beltramello, Alberto, Section of Neuroradiology, University of Verona and University Hospital, Verona, Gerosa, Massimo, and Neurosurgical Clinic, University of Verona and University Hospital, Verona. Wed . "Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part II: Differences in obliteration rates, treatment-obliteration intervals, and prognostic factors". United States. doi:10.1016/J.IJROBP.2005.0.
@article{osti_20793364,
title = {Gamma Knife radiosurgery for cerebral arteriovenous malformations in children/adolescents and adults. Part II: Differences in obliteration rates, treatment-obliteration intervals, and prognostic factors},
author = {Nicolato, Antonio and Lupidi, Francesco and Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona and Sandri, Marco F. Dr. Econom. and Foroni, Roberto and Section of Sterotactic and Functional Neurosurgery, University of Verona and University Hospital, Verona and Zampieri, Piergiuseppe and Section of Neuroradiology, University of Verona and University Hospital, Verona and Mazza, Carlo and Section of Pediatric Neurosurgery, University of Verona and University Hospital, Verona and Pasqualin, Alberto and Neurosurgical Clinic, University of Verona and University Hospital, Verona and Beltramello, Alberto and Section of Neuroradiology, University of Verona and University Hospital, Verona and Gerosa, Massimo and Neurosurgical Clinic, University of Verona and University Hospital, Verona},
abstractNote = {Purpose: To evaluate and compare obliteration rates (OBRs) and treatment-obliteration intervals (TOIs) for cerebral arteriovenous malformations (cAVMs) treated with Gamma Knife radiosurgery in children/adolescents and adults; and to determine factors predicting the OBR and TOI in these two populations. Methods and Materials: This study concerned 62 children/adolescents and 193 adults observed for {>=}3 years. Fisher exact two-tailed and Wilcoxon rank-sum tests, multiple logistics, and Cox proportional hazard models were used for statistical analysis. Results: The overall OBR was 85.5% in children/adolescents and 87.6% in adults (p 0.671), but children/adolescents showed higher 36-month actuarial OBRs (69.35%) and shorter median TOIs (25.7 months) than adults (66.84% and 28.2 months; p 0.006 and p = 0.017, respectively). In children/adolescents, lower Spetzler-Martin grades (p = 0.043) and younger age (p = 0.019) correlated significantly with OBRs, and lower Spetzler-Martin grades (p 0.024) and noneloquent cAVM locations (p = 0.046) with TOIs. In adults, low flow through the cAVM and <6.2-cm{sup 3} volume were associated with both OBR and TOI (p 0.012 and p = 0.002, respectively). Conclusions: The differences in OBRs within 3 years and TOIs, although slight, seem to show that pediatric cAVMs behave differently from those in adults after Gamma Knife radiosurgery.},
doi = {10.1016/J.IJROBP.2005.0},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 64,
place = {United States},
year = {Wed Mar 01 00:00:00 EST 2006},
month = {Wed Mar 01 00:00:00 EST 2006}
}