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- Title
Initial experience of hypofractionated stereotactic radiotherapy as treatment option for large cerebral arteriovenous malformations.
- Authors
Wurm, R.
- Abstract
Purpose: To assess the initial clinical outcome after hypofractionated stereotactic radiotherapy (HSRT) in large cerebral arteriovenous malformations (AVMs). Methods and Materials: We analyzed 61 patients with large cerebral AVMs predominately in eloquent areas following HSRT (55Gy in 11 fractions) between 01/2005-06/2011, mean follow-up 23 months. The median volume was 21.7ccm (range 15-64.4ccm), Spetzler-Martin grade IV 35 (58%), >V 18 (29%), unknown 8 (13%). Prior to HSRT 33 (54.1%) patients had bleed and 16 (29.1%) were initially partially embolized. All patients had at least one clinical neurological symptom prior to HSRT. Results: Improvements on MRI at 6 months were noted in 51 out of 61 patients, and at 24 months in 36 out of 40 patients. The 2-year rate of obliteration on MRI was 50% and the 3-year rate 70%, respectively. At 4 years the angiographically verified obliteration rate was 75%. Preexisting neurologic symptoms improved and remained stable in at least in 50% of patients. Symptomatic MRI changes were found at 6 months in 15 patients (25%), and at 24 months in 3 patients out of 40 patients (7%), respectively. In 2 patients with hemorrhages prior to HSRT new bleds were noted within the first year. Conclusions: HSRT may be an option in patients with large AVMs with acceptable toxicity. Disclosure: No significant relationships.
- Subjects
CEREBRAL arteriovenous malformations; STEREOTACTIC radiotherapy; CANCER patients; CANCER treatment; HEMORRHAGE treatment; THERAPEUTICS
- Publication
Journal of Radiosurgery & SBRT, 2013, Vol 2, p172
- ISSN
2156-4639
- Publication type
Article