Stereotactic Radiosurgery or Fractionated Stereotactic Radiotherapy for Arteriovenous Malformation.
Arteriovenous malformation
Radiosurgery
Radiotherapy
Stereotactic
Journal
World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
14
05
2023
accepted:
21
05
2023
medline:
9
8
2023
pubmed:
29
5
2023
entrez:
28
5
2023
Statut:
ppublish
Résumé
The best management for AVM, particularly high-grade ones and those that have been ruptured before, is still unknown. Data from prospective data lacks support for the best approach. We retrospectively review patients with AVM at a single institution that were treated with radiation or a combination of radiation and embolization. These patients were divided into two groups based on radiation fractionation: SRS and fSRS. One-hundred and thirty-five (135) patients were first assessed and 121 met study criteria. Mean age at treatment was 30.5 years, and most patients were male. The groups were otherwise balanced, except for nidus size. SRS group had smaller lesions (P > 0.005). SRS correlates to better chance of nidus occlusion and lesser chance of retreatment. Complications such as radionecrosis (5%) and bleeding after nidus occlusion (1 patient) were rare. Stereotactic radiosurgery plays an important role on the treatment of AVM. Whenever possible, SRS should be preferred. Data from prospective trials about larger and previously ruptured lesions are needed.
Sections du résumé
BACKGROUND
BACKGROUND
The best management for AVM, particularly high-grade ones and those that have been ruptured before, is still unknown. Data from prospective data lacks support for the best approach.
METHODS
METHODS
We retrospectively review patients with AVM at a single institution that were treated with radiation or a combination of radiation and embolization. These patients were divided into two groups based on radiation fractionation: SRS and fSRS.
RESULTS
RESULTS
One-hundred and thirty-five (135) patients were first assessed and 121 met study criteria. Mean age at treatment was 30.5 years, and most patients were male. The groups were otherwise balanced, except for nidus size. SRS group had smaller lesions (P > 0.005). SRS correlates to better chance of nidus occlusion and lesser chance of retreatment. Complications such as radionecrosis (5%) and bleeding after nidus occlusion (1 patient) were rare.
CONCLUSIONS
CONCLUSIONS
Stereotactic radiosurgery plays an important role on the treatment of AVM. Whenever possible, SRS should be preferred. Data from prospective trials about larger and previously ruptured lesions are needed.
Identifiants
pubmed: 37245668
pii: S1878-8750(23)00707-6
doi: 10.1016/j.wneu.2023.05.075
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e415-e419Informations de copyright
Copyright © 2023 Elsevier Inc. All rights reserved.