Single-fraction stereotactic radiotherapy: a dose–response analysis of arteriovenous malformation obliteration

Touboul, E.; Halabi, Assem Al; Buffat, Laurent; Merienne, L; Huart, Judith; Schlienger, M.; Lefkopoulos, D.; Mammar, Hamid; Missir, O; Méder, Jean-François; Laurent, A.; Housset, M.

doi:10.1016/s0360-3016(98)00115-1

Cited by 71 publications

(26 citation statements)

References 30 publications

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“…Complete AVM obliteration following radiosurgery generally takes 1-3 years [2,4,16,25,30,38,52,55,62,75,77] and the risk of hemorrhage during this latency period remains essentially unchanged from untreated patients [17,55,60] . Obliteration rates following radiosurgery range from 54 to 92% [2,4,16,25,37,38,44,47,55,60,65,68,69,81] .…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Review of Radiosurgery for Cerebral Arteriovenous Malformations: Outcomes, Predictive Factors, and Grading Scales

Starke

Komotar

Hwang

et al. 2008

Stereotact Funct Neurosurg

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The management of cerebral arteriovenous malformations (AVMs) continues to present a challenge to neurosurgeons. The natural history of this condition, as well as the morbidity and mortality of therapeutic interventions, remains incompletely elucidated. Predictive factors and grading scales in AVM management allow risk-benefit analysis of treatment options and comparison of outcomes. Stereotactic radiosurgery is one of the established treatment modalities for AVMs and is generally used to treat lesions that are high risk for surgical resection. Radiosurgery aims to obliterate AVMs and thus prevent hemorrhage or seizure without any new or worsening of existing symptoms. Lesion characteristics and postsurgical complications differ markedly in patientstreated by radiosurgery versus microsurgery. Radiosurgery-based grading systems account for factors that have been associated with various aspects of radiosurgical outcomes including obliteration, hemorrhage, and postoperative complications, particularly those induced by radiation. The purpose of this paper is to describe the most current predictive factors and grading systems for radiosurgical treatment of cerebral AVMs.

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Section: Introductionmentioning

confidence: 99%

A Comprehensive Review of Radiosurgery for Cerebral Arteriovenous Malformations: Outcomes, Predictive Factors, and Grading Scales

Starke

Komotar

Hwang

et al. 2008

Stereotact Funct Neurosurg

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“…Over the past decade, an increasing body of evidence has indicated that larger doses of radiation lead to better cures of AVM and brain metastases after STI [1,2,20,21]. In order to obtain a cure or local control of disease, coverage of the disease by at least 15…”

Section: Discussionmentioning

confidence: 99%

“…Gy has generally been considered necessary for AVM [1] and 18-20 Gy or more was recommended for brain metastases [20,21]. However, such treatment schedules are consistently accompanied by a 3-7% risk of developing radiation necrosis [1,2,3,4,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…However, such treatment schedules are consistently accompanied by a 3-7% risk of developing radiation necrosis [1,2,3,4,20,21].…”

Section: Discussionmentioning

confidence: 99%

“…However, once necrosis occurs in certain areas of the brain responsible for the motor function, visual function, or comprehension or production of speech, it results in permanent neurologic deficits [1][2][3][4]. The development of radiation necrosis is related to the dose of radiation received.…”

Section: Introductionmentioning

confidence: 99%

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Integration of functional brain information into stereotactic irradiation treatment planning using magnetoencephalography and magnetic resonance axonography

Aoyama

Kamada

Shirato

et al. 2004

International Journal of Radiation Oncology*Biology*Physics

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Purpose: To minimize the risk of neurological deficit following stereotactic irradiation, functional brain information was integrated into treatment planning.Materials and Methods: Twenty-one magnetoencephalography and 6 magnetic resonance axonographic images were made in 20 patients in order to evaluate the sensorimotor cortex (n=15 patients, including the corticospinal tract in 6), the visual cortex (n=4) and the Wernicke's area (n=2). One radiation oncologist was asked to formulate a treatment plan without the functional images at first, and then to modify the plan after seeing them. The pre-and post-modification values were compared for the volume of the functional area receiving 15 Gy or more (V15), and the volume of the PTV receiving more than 80% of the prescribed dose (V80-PTV).Results: Fifteen out of 21 plans (71%) were modified after seeing the functional images.After modification, V15 was significantly reduced compared to the values of pre-modification in those 15 sets of plans (p=0.03), whereas there was no significant difference in V80-PTV (p=0.99). During follow-up, a radiation-induced necrosis at the corticospinal tract caused minor motor deficit in one patient for whom MR-axonography was not available in the treatment planning. No other radiation-induced functional deficit was observed in the other patients. AOYAMA H, et al.,3 Conclusions: Integration of MEG and MR-axonography in treatment planning has the potential to reduce the risk of radiation-induced functional dysfunction without deterioration of the dose distribution in the target volume.

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Arteriovenous Malformation

Pollock¹

2008

Principles and Practice of Stereotactic Radiosurgery

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Single-fraction stereotactic radiotherapy: a dose–response analysis of arteriovenous malformation obliteration

Cited by 71 publications

References 30 publications

A Comprehensive Review of Radiosurgery for Cerebral Arteriovenous Malformations: Outcomes, Predictive Factors, and Grading Scales

A Comprehensive Review of Radiosurgery for Cerebral Arteriovenous Malformations: Outcomes, Predictive Factors, and Grading Scales

Integration of functional brain information into stereotactic irradiation treatment planning using magnetoencephalography and magnetic resonance axonography

Arteriovenous Malformation

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