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Title: Complications Following Linear Accelerator Based Stereotactic Radiation for Cerebral Arteriovenous Malformations

Purpose: Primarily, gamma knife centers are predominant in publishing results on arteriovenous malformations (AVM) treatments including reports on risk profile. However, many patients are treated using a linear accelerator-most of these at smaller centers. Because this setting is different from a large gamma knife center, the risk profile at Linac departments could be different from the reported experience. Prescribed radiation doses are dependent on AVM volume. This study details results from a medium sized Linac department center focusing on risk profiles. Method and Materials: A database was searched for all patients with AVMs. We included 50 consecutive patients with a minimum of 24 months follow-up (24-51 months). Results: AVM occlusion was verified in 78% of patients (39/50). AVM occlusion without new deficits (excellent outcome) was obtained in 44%. Good or fair outcome (AVM occlusion with mild or moderate new deficits) was seen in 30%. Severe complications after AVM occlusion occurred in 4% with a median interval of 15 months after treatment (range, 1-26 months). Conclusions: We applied an AVM grading score developed at the Mayo Clinic to predict probable outcome after radiosurgery in a large patient population treated with Gamma knife. A cutoff above and below a score of 1.5more » could not discriminate between the likelihood of having an excellent outcome (approximately 45%). The chance of having an excellent or good outcome was slightly higher in patients with an AVM score below 1.5 (64% vs. 57%).« less
Authors:
 [1] ; ;  [2] ; ;  [1]
  1. Department of Neurosurgery, Rigshospitalet, Copenhagen (Denmark)
  2. Department of Radiation Oncology, Rigshospitalet, Copenhagen (Denmark)
Publication Date:
OSTI Identifier:
21372306
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 77; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2009.05.048; PII: S0360-3016(09)00831-1; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; CEREBRUM; LINEAR ACCELERATORS; MALFORMATIONS; RADIATION DOSES; RADIOTHERAPY; SURGERY ACCELERATORS; BODY; BRAIN; CENTRAL NERVOUS SYSTEM; DISEASES; DOSES; MEDICINE; NERVOUS SYSTEM; NUCLEAR MEDICINE; ORGANS; PATHOLOGICAL CHANGES; RADIOLOGY; THERAPY