Stereotactic radiosurgery (SRS) for patients with brainstem cerebral cavernous malformations (CCMs): an international, multicentric study.

Humans Radiosurgery / methods Female Male Hemangioma, Cavernous, Central Nervous System / surgery Adult Middle Aged Brain Stem Adolescent Retrospective Studies Young Adult Child Treatment Outcome Aged Brain Stem Neoplasms / radiotherapy Child, Preschool Risk Factors
Cerebral cavernous malformation Hemorrhagic Stereotactic radiosurgery brainstem

Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
29 10 2024
Historique:
received: 11 02 2024
accepted: 21 10 2024
medline: 30 10 2024
pubmed: 30 10 2024
entrez: 30 10 2024
Statut: epublish

Résumé

Brainstem cerebral cavernous malformations (CCM) are clinically more aggressive compared to superficial CCMs. Due to their location, resection can be challenging, making stereotactic radiosurgery (SRS) an attractive alternative for symptomatic patient. Brainstem CCM patients (n = 170) were treated with Gamma Knife SRS at 11 radiosurgical centers. Hemorrhagic risk reduction, risk factors of post-SRS hemorrhage, and clinical outcomes were retrospectively analyzed. Most patients had a single (165/170 patients) brainstem CCMs treated; the majority of CCMs (165/181) presented with bleeding. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM (HR: 0.17, p < 0.001) using recurrent multivariate analysis. The annual hemorrhage rate decreased from 14.8 per 100 CCM-years before SRS to 2.3 after treatment. Using univariate Cox-analysis, the probability of a new hemorrhages after SRS was reduced for patient older than 35 years (HR = 0.21, p = 0.002) and increased with a margin dose > 13 Gy (HR = 2.57, p = 0.044). Adverse radiation effect (ARE) occurred in 9 patients (5.3%) and was symptomatic in four (2.4%). At a median follow-up of 3.4 years (Inter-quartile range: 5.4), 13 patients (8.0%) had a worsened clinical status, with the treated CCM being the cause in 5.6% (10) of the patients. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM and conveyed this benefit with a low risk of advrse radiation effects (ARE) and worsening clinical status.

Identifiants

DOI: 10.1038/s41598-024-77140-z PMID: 39472707
pubmed: 39472707
doi: 10.1038/s41598-024-77140-z
pii: 10.1038/s41598-024-77140-z
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

25933

Informations de copyright

© 2024. The Author(s).

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Auteurs

Sam Dayawansa (S)

Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA. samwansa20@gmail.com.

Chloe Dumot (C)

Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Department of Neurological Surgery, Hospices Civils de Lyon, Lyon, France.

Georgios Mantziaris (G)

Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.

Zhiyuan Xu (Z)

Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.

Stylianos Pikis (S)

Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.

Selcuk Peker (S)

Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.

Yavuz Samanci (Y)

Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.

Gokce D Ardor (GD)

Department of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.

Ahmed M Nabeel (AM)

Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Neurosurgery Department, Faculty of Medicine, Benha University, Qalubya, Egypt.

Wael A Reda (WA)

Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Department of Neurosurgery, Ain Shams University, Cairo, Egypt.

Sameh R Tawadros (SR)

Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Department of Neurosurgery, Ain Shams University, Cairo, Egypt.

Khaled Abdelkarim (K)

Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Department of Clinical Oncology, Ain Shams University, Cairo, Egypt.

Amr M N El-Shehaby (AMN)

Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Department of Neurosurgery, Ain Shams University, Cairo, Egypt.

Reem M Emad Eldin (RME)

Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, Egypt.

Ahmed H Elazzazi (AH)

Extended Modular Program- Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Nuria Martínez Moreno (NM)

Department of Radiosurgery, Rúber Internacional Hospital, Madrid, Spain.

Roberto Martínez Álvarez (RM)

Department of Radiosurgery, Rúber Internacional Hospital, Madrid, Spain.

Roman Liscak (R)

Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.

Jaromir May (J)

Department of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.

David Mathieu (D)

Division of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, QC, Canada.

Jean-Nicolas Tourigny (JN)

Division of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, QC, Canada.

Manjul Tripathi (M)

Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Akshay Rajput (A)

Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Narendra Kumar (N)

Department of Radiation Therapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Rupinder Kaur (R)

Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Piero Picozzi (P)

Department of Neurosurgery, Scientific Institute for Research, Hospitalization and Healthcare - IRCCS Humanitas Research Hospital, Milan, Italy.

Andrea Franzini (A)

Department of Neurosurgery, Scientific Institute for Research, Hospitalization and Healthcare - IRCCS Humanitas Research Hospital, Milan, Italy.

Herwin Speckter (H)

Dominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.

Wenceslao Hernandez (W)

Dominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.

Anderson Brito (A)

Dominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.

Ronald E Warnick (RE)

Gamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati, OH, USA.

Juan Alzate (J)

Department of Neurosurgery, NYU Langone, New York City, NY, USA.

Douglas Kondziolka (D)

Department of Neurosurgery, NYU Langone, New York City, NY, USA.

Greg N Bowden (GN)

Department of Neurosurgery and Department of Oncology, University of Alberta, Edmonton, AB, Canada.

Samir Patel (S)

Division of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, AB, Canada.

Jason P Sheehan (JP)

Department of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Techniques d'investigation › Techniques stéréotaxiques › Radiochirurgie › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Malformations › Malformations du système nerveux › Malformations vasculaires du système nerveux central › Hémangiome caverneux du système nerveux central › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Système nerveux › Système nerveux central › Encéphale › Tronc cérébral › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Adolescent › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Jeune adulte › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Maladies du système nerveux › Tumeurs du système nerveux › Tumeurs du système nerveux central › Tumeurs du cerveau › Tumeurs sous-tentorielles › Tumeurs du tronc cérébral › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Enfant d'âge préscolaire › Stereotactic radiosurgery (SRS) for patients...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Stereotactic radiosurgery (SRS) for patients...