Complications following linear accelerator based stereotactic radiation for cerebral arteriovenous malformations.

Abstract

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 1.5 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%).

• Authors: Jane Skjøth-Rasmussen, Henrik Roed, Lars Ohlhues, Bo Jespersen, Marianne Juhler
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 77 Issue 2 Pg. 542-7 (Jun 01 2010) ISSN: 1879-355X [Electronic] United States
• PMID: 19796884 (Publication Type: Journal Article)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Topics

• Adolescent
• Adult
• Aged
• Child
• Female
• Humans
• Intracranial Arteriovenous Malformations (surgery)
• Male
• Middle Aged
• Particle Accelerators
• Radiosurgery (adverse effects, instrumentation, methods)
• Radiotherapy Dosage
• Risk Factors
• Treatment Outcome
• Young Adult