Bragg-peak proton-beam therapy for arteriovenous malformations of the brain

Kjellberg, R N; Hanamura, T; Davis, K R; Lyons, S L; Adams, R D

doi:10.1056/NEJM198308043090503

Title: Bragg-peak proton-beam therapy for arteriovenous malformations of the brain

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Abstract

Patients with arteriovenous malformations of the brain, who are subject to disabling or fatal recurrent hemorrhage, seizures, severe headache, and progressive neurologic deficits, may be considered unsuitable for conventional therapies (craniotomy with excision or embolization), usually because of the location, size, or operative risk of the lesion. We have treated such patients with stereotactic Bragg-peak proton-beam therapy and report the follow-up of 74 of the first 75, 2 to 16 years after treatment. Proton-beam therapy is intended to induce subendothelial deposition of collagen and hyaline substance, which narrows the lumens of small vessels and thickens the walls of the malformation during the first 12 to 24 months after the procedure. Two deaths from hemorrhage occurred in the first 12 months after treatment, but no lethal or disabling hemorrhages occurred after this interval. Seizures, headaches, and progressive neurologic deficits were in most cases arrested or improved. Bragg-peak proton-beam therapy appears to be a useful technique for treatment of intracranial arteriovenous malformations, especially those that are unsuitable for treatment by other methods.

Authors:: Kjellberg, R N; Hanamura, T; Davis, K R; Lyons, S L; Adams, R D

Publication Date:: Thu Aug 04 00:00:00 EDT 1983

Research Org.:: Massachusetts General Hospital, Boston

OSTI Identifier:: 6743014

Resource Type:: Journal Article

Journal Name:: N.Engl. J. Med.; (United States)

Additional Journal Information:: Journal Volume: 309:5

Country of Publication:: United States

Language:: English

Subject:: 63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; BRAIN; BIOLOGICAL RADIATION EFFECTS; CONGENITAL MALFORMATIONS; HEMORRHAGE; RADIOINDUCTION; RADIOTHERAPY; SIDE EFFECTS; BRAGG CURVE; PATIENTS; PROTONS; BARYONS; BIOLOGICAL EFFECTS; BODY; CENTRAL NERVOUS SYSTEM; DIAGRAMS; ELEMENTARY PARTICLES; FERMIONS; HADRONS; MALFORMATIONS; MEDICINE; NERVOUS SYSTEM; NUCLEAR MEDICINE; NUCLEONS; ORGANS; PATHOLOGICAL CHANGES; RADIATION EFFECTS; RADIOLOGY; SYMPTOMS; THERAPY; 560151* - Radiation Effects on Animals- Man; 550603 - Medicine- External Radiation in Therapy- (1980-)

Citation Formats


                    Kjellberg, R N, Hanamura, T, Davis, K R, Lyons, S L, and Adams, R D. Bragg-peak proton-beam therapy for arteriovenous malformations of the brain.  United States: N. p., 1983. 
        Web.  doi:10.1056/NEJM198308043090503.

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                    Kjellberg, R N, Hanamura, T, Davis, K R, Lyons, S L, & Adams, R D. Bragg-peak proton-beam therapy for arteriovenous malformations of the brain.  United States.  https://doi.org/10.1056/NEJM198308043090503

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                    Kjellberg, R N, Hanamura, T, Davis, K R, Lyons, S L, and Adams, R D. 1983.  
        "Bragg-peak proton-beam therapy for arteriovenous malformations of the brain".  United States.  https://doi.org/10.1056/NEJM198308043090503.

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@article{osti_6743014,

  title        = {Bragg-peak proton-beam therapy for arteriovenous malformations of the brain},

  author       = {Kjellberg, R N and Hanamura, T and Davis, K R and Lyons, S L and Adams, R D},

  abstractNote = {Patients with arteriovenous malformations of the brain, who are subject to disabling or fatal recurrent hemorrhage, seizures, severe headache, and progressive neurologic deficits, may be considered unsuitable for conventional therapies (craniotomy with excision or embolization), usually because of the location, size, or operative risk of the lesion. We have treated such patients with stereotactic Bragg-peak proton-beam therapy and report the follow-up of 74 of the first 75, 2 to 16 years after treatment. Proton-beam therapy is intended to induce subendothelial deposition of collagen and hyaline substance, which narrows the lumens of small vessels and thickens the walls of the malformation during the first 12 to 24 months after the procedure. Two deaths from hemorrhage occurred in the first 12 months after treatment, but no lethal or disabling hemorrhages occurred after this interval. Seizures, headaches, and progressive neurologic deficits were in most cases arrested or improved. Bragg-peak proton-beam therapy appears to be a useful technique for treatment of intracranial arteriovenous malformations, especially those that are unsuitable for treatment by other methods.},

  doi          = {10.1056/NEJM198308043090503},

  url          = {https://www.osti.gov/biblio/6743014},
  journal      = {N.Engl. J. Med.; (United States)},
number       = ,

  volume       = 309:5,

  place        = {United States},

  year         = {Thu Aug 04 00:00:00 EDT 1983},

  month        = {Thu Aug 04 00:00:00 EDT 1983}

}

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