Radiosurgery with a linear accelerator in cerebral arteriovenous malformations

Esteves, Sérgio Carlos Barros; Nadalin, Wladimir; Piske, Ronie Leo; Benabou, Salomon; Souza, Evandro de; Oliveira, Antonio Carlos Zuliani de

doi:10.1590/s0104-42302008000200023

Cited by 2 publications

(1 citation statement)

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“…In this study, 73.7% of patients presented with hemorrhage before SRS, which may be associated with the fact that over 50% of our patients had AVMs in a deep location. The AVMs' cumulative probability of obliteration in five years was 82.47%, results that are similar to those reported by other series [8,21,22,[27][28][29][30][31][32][33][34][40][41][42] . Complete AVMs occlusion was higher compared with that reported by Skjoth-Rasmussen et al [42] , who reported 78% occlusion in small AVMs of less than 10 cm in volume.…”

Section: Discussionsupporting

confidence: 88%

Linac Stereotactic Radiosurgery for the Treatment of Small Arteriovenous Malformations: Lower Doses Can Be Equally Effective

Flores¹,

Sallabanda²,

Santos³

et al. 2011

Stereotact Funct Neurosurg

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Objective: The purpose of this study was to examine the efficacy and toxicity of treating small arteriovenous malformations (AVMs) (≤3 cm in diameter) with a median marginal applied dose of 14 Gy. Methods: Two hundred and thirteen patients diagnosed with AVMs were treated between January 1991 and December 2005. Seventy-three percent of the patients had hemorrhaged prior to treatment, 13% had had previous surgery and 19.2% had had previous embolization. The median follow-up duration was 48.1 months. Results: The Kaplan-Meier analysis estimated that the 36-month obliteration rate was 65.5% for patients undergoing their first stereotactic radiosurgery (SRS) and 68.3% for those undergoing repeated SRS. The Kaplan-Meier analysis estimated the 60-month AVMs obliteration rate for the entire cohort to be 82.4%. The median time to AVM obliteration was 40 ± 2.8 months. We found a statistically significant relationship between the time of obliteration and the following factors: site of the AVMs (sites other than brainstem), a higher prescribed dose and a positive history of previous hemorrhage. Thirteen patients (7.6%) experienced toxicities. Conclusions: SRS was an effective and safe treatment for AVMs ≤3 cm in diameter, with acceptable toxicity.

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